Relation of Atrial Fibrillation in Acute Myocardial Infarction to In-Hospital Complications and Early Hospital Readmission
| Autor: | Kevin C. Floyd, David D. McManus, Amartya Kundu, Kevin O'Day, Amir Y. Shaikh, Jane S. Saczynski, Jorge L. Yarzebski, Darleen M. Lessard, Robert J. Goldberg, Mohammed Akhter, Ramses Thabet, Chad E. Darling |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction 030204 cardiovascular system & hematology Patient Readmission Article 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Atrial Fibrillation Odds Ratio Prevalence medicine Humans Hospital Mortality cardiovascular diseases 030212 general & internal medicine Myocardial infarction Stroke Aged Retrospective Studies Aged 80 and over Inpatients business.industry Incidence Mortality rate Cardiogenic shock Atrial fibrillation Odds ratio Prognosis medicine.disease Massachusetts Heart failure Cardiology Myocardial infarction complications Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 117:1213-1218 |
| ISSN: | 0002-9149 |
| Popis: | Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) and contributes to high rates of in-hospital adverse events. However, there are few contemporary studies examining rates of AF in the contemporary era of AMI or the impact of new-onset AF on key in-hospital and post-discharge outcomes. We examined trends in AF among 6,384 residents of Worcester, Massachusetts who were hospitalized with confirmed AMI during 7 biennial periods between 1999 and 2011. Multivariate logistic regression analysis was used to examine associations between occurrence of AF and various in-hospital and post-discharge complications. The overall incidence of AF complicating AMI was 10.8%. Rates of new-onset AF increased from 1999 to 2003 (9.8% to 13.2%), and declined thereafter. In multivariable adjusted models, patients developing new-onset AF following AMI were at higher risk for inhospital stroke [Odds Ratio (OR) 2.5, 95% Confidence Interval (CI) 1.6–4.1], heart failure [OR 2.0, 95% CI 1.7 to 2.4], cardiogenic shock [OR 3.7, 95% CI 2.8–4.9] and death [OR 2.3, 95% CI 1.9 to 3.0] than patients without AF. Development of AF during hospitalization for AMI was associated with higher rates of readmission within 30-days after discharge [21.7% vs. 16.0%], but no significant difference was noted in early post-discharge 30-day all-cause mortality rates [8.3% vs. 5.1%]. In conclusion, new-onset AF following AMI is strongly related to in-hospital complications of AMI as well as higher short-term readmission rates. |
| Databáze: | OpenAIRE |
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