New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality
Abstract Backgrund: New-onset atrial fibrillation complicating acute myocardial infarction represents an important challenge, with prognostic significance. Objective: To study the incidence, impact on therapy and mortality, and to identify predictors of development of new-onset atrial fibrillation...
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doaj-c38e85c809654b17a379a6c76899513e2020-11-25T02:43:18ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-417010.5935/abc.20190190S0066-782X2019005018103New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And MortalityKisa Hyde CongoAdriana BeloJoão CarvalhoDavid NevesRui GuerreiroJoão António PaisDiogo BrásMafalda CarringtonBruno PiçarraAna Rita SantosJosé AguiarAbstract Backgrund: New-onset atrial fibrillation complicating acute myocardial infarction represents an important challenge, with prognostic significance. Objective: To study the incidence, impact on therapy and mortality, and to identify predictors of development of new-onset atrial fibrillation during hospital stay for ST-segment elevation myocardial infarction. Methods: We studied all patients with ST-elevation myocardial infarction included consecutively, between 2010 and 2017, in a Portuguese national registry and compared two groups: 1 - no atrial fibrillation and 2 - new-onset atrial fibrillation. We adjusted a logistic regression model data analysis to assess the impact of new-onset atrial fibrillation on in-hospital mortality and to identify independent predictors of its development. A p value < 0.05 was considered significant. Results: We studied 6325 patients, and new-onset atrial fibrillation was found in 365 (5.8%). Reperfusion was successfully accomplished in both groups with no difference regarding type of reperfusion. In group 2, therapy with beta-blockers and angiotensin-conversion enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs) was less frequent, 20.6% received anticoagulation at discharge and 16.1% were on triple therapy. New-onset atrial fibrillation was associated with more in-hospital complications and mortality. However, it was not found as an independent predictor of in-hospital mortality. We identified age, prior stroke, inferior myocardial infarction and complete atrioventricular block as independent predictors of new-onset atrial fibrillation. Conclusion: New-onset atrial fibrillation remains a frequent complication of myocardial infarction and is associated with higher rate of complications and in-hospital mortality. Age, prior stroke, inferior myocardial infarction and complete atrioventricular block were independent predictors of new onset atrial fibrillation. Only 36.7% of the patients received anticoagulation at discharge.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005018103&lng=en&tlng=enFibrilação AtrialInfarto do Miocárdio com Supradesnível do Segmento ST/complicaçõesHospitalizaçãoMortalidadeAnti-HipertensivosAnticoagulantes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kisa Hyde Congo Adriana Belo João Carvalho David Neves Rui Guerreiro João António Pais Diogo Brás Mafalda Carrington Bruno Piçarra Ana Rita Santos José Aguiar |
spellingShingle |
Kisa Hyde Congo Adriana Belo João Carvalho David Neves Rui Guerreiro João António Pais Diogo Brás Mafalda Carrington Bruno Piçarra Ana Rita Santos José Aguiar New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality Arquivos Brasileiros de Cardiologia Fibrilação Atrial Infarto do Miocárdio com Supradesnível do Segmento ST/complicações Hospitalização Mortalidade Anti-Hipertensivos Anticoagulantes |
author_facet |
Kisa Hyde Congo Adriana Belo João Carvalho David Neves Rui Guerreiro João António Pais Diogo Brás Mafalda Carrington Bruno Piçarra Ana Rita Santos José Aguiar |
author_sort |
Kisa Hyde Congo |
title |
New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality |
title_short |
New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality |
title_full |
New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality |
title_fullStr |
New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality |
title_full_unstemmed |
New-Onset Atrial Fibrillation in St-Segment Elevation Myocardial Infarction: Predictors and Impact on Therapy And Mortality |
title_sort |
new-onset atrial fibrillation in st-segment elevation myocardial infarction: predictors and impact on therapy and mortality |
publisher |
Sociedade Brasileira de Cardiologia (SBC) |
series |
Arquivos Brasileiros de Cardiologia |
issn |
1678-4170 |
description |
Abstract Backgrund: New-onset atrial fibrillation complicating acute myocardial infarction represents an important challenge, with prognostic significance. Objective: To study the incidence, impact on therapy and mortality, and to identify predictors of development of new-onset atrial fibrillation during hospital stay for ST-segment elevation myocardial infarction. Methods: We studied all patients with ST-elevation myocardial infarction included consecutively, between 2010 and 2017, in a Portuguese national registry and compared two groups: 1 - no atrial fibrillation and 2 - new-onset atrial fibrillation. We adjusted a logistic regression model data analysis to assess the impact of new-onset atrial fibrillation on in-hospital mortality and to identify independent predictors of its development. A p value < 0.05 was considered significant. Results: We studied 6325 patients, and new-onset atrial fibrillation was found in 365 (5.8%). Reperfusion was successfully accomplished in both groups with no difference regarding type of reperfusion. In group 2, therapy with beta-blockers and angiotensin-conversion enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs) was less frequent, 20.6% received anticoagulation at discharge and 16.1% were on triple therapy. New-onset atrial fibrillation was associated with more in-hospital complications and mortality. However, it was not found as an independent predictor of in-hospital mortality. We identified age, prior stroke, inferior myocardial infarction and complete atrioventricular block as independent predictors of new-onset atrial fibrillation. Conclusion: New-onset atrial fibrillation remains a frequent complication of myocardial infarction and is associated with higher rate of complications and in-hospital mortality. Age, prior stroke, inferior myocardial infarction and complete atrioventricular block were independent predictors of new onset atrial fibrillation. Only 36.7% of the patients received anticoagulation at discharge. |
topic |
Fibrilação Atrial Infarto do Miocárdio com Supradesnível do Segmento ST/complicações Hospitalização Mortalidade Anti-Hipertensivos Anticoagulantes |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005018103&lng=en&tlng=en |
work_keys_str_mv |
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