Impact of new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-12-11 DOI:10.1007/s10840-024-01941-5

Judith Minder, Diego Mannhart, Sarah Brunner, Gianluca Di Bari, Sven Knecht, Philipp Krisai, Thomas Nestelberger, Jasper Boeddinghaus, Gregor Leibundgut, Christoph Kaiser, Christian Mueller, Stefan Osswald, Christian Sticherling, Michael Kühne, Patrick Badertscher

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引用次数: 0

Abstract

Background: New-onset atrial fibrillation (NOAF) complicating ST-segment elevation myocardial infarction (STEMI) remains clinically challenging. The aim of this study was to assess the incidence of NOAF, identify risk factors for the development of atrial fibrillation (AF), and analyze the impact on patient care, therapy, and outcomes during long-term follow-up.

Methods: This retrospective single-center study reviewed consecutive patients undergoing coronary angiography (CAG) for acute STEMI between May 2015 and September 2023. Patients were stratified in NOAF, defined as AF diagnosed during the index hospitalization or within 12 months of follow-up, AF prior to the hospitalization for STEMI, and patients with no AF.

Results: We analyzed 1301 consecutive patients undergoing CAG for STEMI. NOAF was detected in 112 patients (9.8%), and 68 patients (5.2%) had prior AF. NOAF patients were 74% males, with a mean age of 69 ± 11 years. During a median follow-up of 683 days, the rates of stroke were 10% in patients with NOAF compared to 3.8% (p = 0.001) in patients without AF. Major bleeding occurred in 7% vs. 1.7%, p = 0.001, and death in 16% vs. 6.8%, p < 0.001 of patients with NOAF vs. no AF.

Conclusion: NOAF was detected in almost 1 out of 10 STEMI patients and was associated with a higher rate of stroke, major bleeding, and death as in patients with no AF and with similar rates compared with prior AF. Future studies assessing optimal anticoagulation therapy in this challenging patient population are warranted.

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st段抬高型心肌梗死患者新发房颤的影响。

背景：新发心房颤动（NOAF）合并st段抬高型心肌梗死（STEMI）仍然具有临床挑战性。本研究的目的是评估NOAF的发生率，确定心房颤动（AF）发展的危险因素，并分析其对患者护理、治疗和长期随访结果的影响。方法：本回顾性单中心研究回顾了2015年5月至2023年9月期间连续接受冠状动脉造影（CAG）治疗急性STEMI的患者。对NOAF患者进行分层，NOAF定义为住院期间或随访12个月内诊断的房颤，STEMI住院前的房颤，以及无房颤的患者。结果：我们分析了1301例连续接受STEMI CAG的患者。112例（9.8%）患者检出NOAF， 68例（5.2%）患者既往有房颤。NOAF患者中男性占74%，平均年龄69±11岁。在683天的中位随访期间，NOAF患者卒中发生率为10%，而无房颤患者卒中发生率为3.8% （p = 0.001）。大出血发生率为7%对1.7%,p = 0.001，死亡发生率为16%对6.8%,p。在几乎1 / 10的STEMI患者中检测到NOAF，与无房颤患者相比，NOAF与更高的卒中、大出血和死亡发生率相关，与房颤患者相比，NOAF与房颤患者的发生率相似。在这一具有挑战性的患者群体中，评估最佳抗凝治疗的未来研究是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.