De novo and pre-existing atrial fibrillation in acute coronary syndromes: impact on prognosis and cardiovascular events in long-term follow-up
| Autor: | Mariusz Ga Sior, Krzysztof Myrda, Piotr Buchta, Katarzyna Mizia-Stec, Michał Skrzypek, Zbigniew Kalarus |
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| Rok vydání: | 2021 |
| Předmět: |
Acute coronary syndrome
medicine.medical_specialty medicine.medical_treatment Aftercare Critical Care and Intensive Care Medicine Internal medicine Atrial Fibrillation Medicine Humans Myocardial infarction Acute Coronary Syndrome Stroke Aldosterone inhibitor business.industry Percutaneous coronary intervention Atrial fibrillation General Medicine medicine.disease Prognosis Patient Discharge Heart failure Cardiology Cardiology and Cardiovascular Medicine business TIMI Follow-Up Studies |
| Zdroj: | European heart journal. Acute cardiovascular care. 10(10) |
| ISSN: | 2048-8734 |
| Popis: | Aims The aim of the study was to compare in-hospital and long-term prognosis in patients with acute coronary syndromes (ACS) and de novo vs. pre-existing atrial fibrillation (AF). Atrial fibrillation increases the risk of serious adverse events including death in patients with ACS. However, it is unclear whether de novo and pre-existing AF portend a different risk. Methods and results We analysed the incidence, clinical characteristics, and in-hospital and long-term outcomes in patients with AF and ACS based on combined data from Polish Registry of Acute Coronary Syndrome (PL-ACS) (n = 581 843) and SILICARD (n = 852 063) databases. Atrial fibrillation at admission was diagnosed in of 6.16% patients [de novo: 1129 (2.46%); pre-existing: 1691 (3.7%)]. Groups were compared (N = 1023 vs. 1023) after matching for relevant clinical factors. De novo and pre-existing AF differed in in-hospital diuretic (52% vs. 58%; P = 0.008) and aldosterone inhibitor (27.5% vs. 32.5%; P = 0.02) use, Thrombolysis In Myocardial Infarction (TIMI) flow before percutaneous coronary intervention (P = 0.016), and diuretic (52.1% vs. 58%; P = 0.008) and oral anticoagulant (27.5% vs. 32.5%; P = 0.018) use at discharge. In-hospital mortality in the de novo AF group was significantly higher (13.1% vs. 8.31%; P = 0.0005). Post-discharge 12-month survival was similar between groups (14.5% vs. 15.3%, P = 0.63). Long-term re-hospitalization due to heart failure (22.7% vs. 17.2%; P Conclusion De novo AF accounts for 40% of all AF cases in ACS patients and is an unfavourable in-hospital prognostic factor. The occurrence of de novo AF during ACS should require special attention and caution in the treatment of these patients. |
| Databáze: | OpenAIRE |
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