New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke
Objective To investigate the long-term prognostic implications of transient new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).Design Retrospective observational study.Setting Single tertiary centre.Participants This study included 2523 patients who presented with...
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e039600.full |
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| author | Si-Hyuck Kang Chang-Hwan Yoon Dong-Ju Choi Ji Hyun Lee Jin Joo Park Tae-Jin Youn In-Ho Chae Sun-Hwa Kim Wonjae Lee Youngjin Cho IL-Young Oh Jung-Won Suh Young-Seok Cho |
| author_facet | Si-Hyuck Kang Chang-Hwan Yoon Dong-Ju Choi Ji Hyun Lee Jin Joo Park Tae-Jin Youn In-Ho Chae Sun-Hwa Kim Wonjae Lee Youngjin Cho IL-Young Oh Jung-Won Suh Young-Seok Cho |
| author_sort | Si-Hyuck Kang |
| collection | DOAJ |
| description | Objective To investigate the long-term prognostic implications of transient new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).Design Retrospective observational study.Setting Single tertiary centre.Participants This study included 2523 patients who presented with AMI from 3 June 2003 to 24 February 2015, after the exclusion of those with prior AF or in-hospital death.Outcome measures Patients were divided into three groups according to the occurrence and type of new-onset AF: (1) sinus rhythm (SR) group; (2) paroxysmal AF (PaAF: AF converted to SR prior to discharge) group and (3) persistent AF (PeAF: AF persisted during the hospitalisation) group. Post-discharge all-cause mortality and stroke incidences were compared between the groups.Results New-onset AF was observed in 271 patients (10.7%; PaAF: 230, PeAF: 41). The median follow-up period was 7.2 years (IQR: 5.2–9.4). The incidence of all-cause death and stroke was highest in the PeAF group, followed by the PaAF and SR groups (all-cause mortality: 48.8% vs 26.5% vs 14.7%, p<0.001; stroke 22.0% vs 8.3% vs 4.4%, p<0.001). In the multivariable analysis, PaAF and PeAF were associated with an increased risk of stroke (PaAF, HR: 1.972, 95% CI: 1.162–3.346; PeAF, HR: 5.160, CI: 2.242–11.873) compared with SR. The PaAF group showed a higher incidence of post-discharge AF than the SR group (29.1% vs 4.2%, p<0.001).Conclusions New-onset AF following AMI is associated with poor long-term outcomes. Even when AF episodes are brief and are converted to SR, new-onset AF remains associated with an increased risk of recurrent AF and stroke. |
| format | Article |
| id | doaj-art-6d2125afd91c4be29f073e20f15a7647 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-6d2125afd91c4be29f073e20f15a76472025-01-08T20:25:08ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-039600New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of strokeSi-Hyuck Kang0Chang-Hwan Yoon1Dong-Ju Choi2Ji Hyun Lee3Jin Joo Park4Tae-Jin Youn5In-Ho Chae6Sun-Hwa Kim7Wonjae Lee8Youngjin Cho9IL-Young Oh10Jung-Won Suh11Young-Seok Cho12Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, The Republic of Korea2 Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, The Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, The Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea2 Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, The Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, The Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, The Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, The Republic of Korea1 Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, The Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, The Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, The Republic of KoreaDivision of Cardiology and Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, The Republic of KoreaObjective To investigate the long-term prognostic implications of transient new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).Design Retrospective observational study.Setting Single tertiary centre.Participants This study included 2523 patients who presented with AMI from 3 June 2003 to 24 February 2015, after the exclusion of those with prior AF or in-hospital death.Outcome measures Patients were divided into three groups according to the occurrence and type of new-onset AF: (1) sinus rhythm (SR) group; (2) paroxysmal AF (PaAF: AF converted to SR prior to discharge) group and (3) persistent AF (PeAF: AF persisted during the hospitalisation) group. Post-discharge all-cause mortality and stroke incidences were compared between the groups.Results New-onset AF was observed in 271 patients (10.7%; PaAF: 230, PeAF: 41). The median follow-up period was 7.2 years (IQR: 5.2–9.4). The incidence of all-cause death and stroke was highest in the PeAF group, followed by the PaAF and SR groups (all-cause mortality: 48.8% vs 26.5% vs 14.7%, p<0.001; stroke 22.0% vs 8.3% vs 4.4%, p<0.001). In the multivariable analysis, PaAF and PeAF were associated with an increased risk of stroke (PaAF, HR: 1.972, 95% CI: 1.162–3.346; PeAF, HR: 5.160, CI: 2.242–11.873) compared with SR. The PaAF group showed a higher incidence of post-discharge AF than the SR group (29.1% vs 4.2%, p<0.001).Conclusions New-onset AF following AMI is associated with poor long-term outcomes. Even when AF episodes are brief and are converted to SR, new-onset AF remains associated with an increased risk of recurrent AF and stroke.https://bmjopen.bmj.com/content/10/9/e039600.full |
| spellingShingle | Si-Hyuck Kang Chang-Hwan Yoon Dong-Ju Choi Ji Hyun Lee Jin Joo Park Tae-Jin Youn In-Ho Chae Sun-Hwa Kim Wonjae Lee Youngjin Cho IL-Young Oh Jung-Won Suh Young-Seok Cho New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke BMJ Open |
| title | New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke |
| title_full | New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke |
| title_fullStr | New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke |
| title_full_unstemmed | New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke |
| title_short | New-onset paroxysmal atrial fibrillation in acute myocardial infarction: increased risk of stroke |
| title_sort | new onset paroxysmal atrial fibrillation in acute myocardial infarction increased risk of stroke |
| url | https://bmjopen.bmj.com/content/10/9/e039600.full |
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