Implications of Atrial Fibrillation in Patients with Myocardial Infarction with Non-obstructive Coronary Arteries.

Q3 Medicine

Critical Pathways in Cardiology Pub Date : 2025-04-30 DOI:10.1097/HPC.0000000000000391

Abdul Rasheed Bahar, Yasemin Bahar, Paawanjot Kaur, George Kidess, Mohamad Hasan Jawadi, Mohamed S Alrayyashi, Olayiwola Bolaji, Timir K Paul, M Chadi Alraies

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引用次数: 0

Abstract

Background: Myocardial Infarction with non-obstructive coronary arteries (MINOCA) is defined as myocardial infarction with <50% stenosis of coronary arteries. Atrial fibrillation (AF) is a common arrhythmia that may influence MINOCA outcomes.

Methods: We performed a retrospective analysis of the National Inpatient Sample (2016-2021), identifying MINOCA patients with and without AF using ICD-10-CM codes. Multivariable mixed-effects logistic regression and propensity score matching were applied to control for confounders and assess outcomes.

Results: Of 94,840 MINOCA patients, 28,270 (30%) had AF. AF was associated with higher in-hospital mortality (3.74% vs. 2.75%, p=0.004), acute heart failure (38.33% vs. 34.97%, p<0.001), sudden cardiac arrest (2.54% vs. 1.73%, p<0.050), and cardiogenic shock (3.11% vs. 1.56%, p<0.001). AF independently predicted in-hospital mortality (adjusted odds ratio; aOR 1.3, 95% CI: 1.07-1.58, p<0.001), heart failure (aOR: 1.48, 95% CI: 1.38-1.59, p<0.001), cardiogenic shock (aOR: 1.85, 95% CI: 1.48-2.30, p<0.001), and acute kidney injury (aOR: 1.15, 95% CI: 1.07-1.24, p<0.001). There were no significant differences in percutaneous coronary intervention, mechanical circulatory support, or defibrillator use (p>0.050).

Conclusion: AF in MINOCA is associated with worse in-hospital outcomes, including mortality, heart failure, acute kidney injury, and cardiogenic shock. AF may be a key prognostic marker in this population, warranting further research.

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非阻塞性冠状动脉心肌梗死患者心房颤动的意义。

背景：非阻塞性冠状动脉心肌梗死（MINOCA）被定义为心肌梗死，方法：我们对全国住院患者样本（2016-2021）进行了回顾性分析，使用ICD-10-CM代码识别伴有和不伴有房颤的MINOCA患者。采用多变量混合效应逻辑回归和倾向评分匹配来控制混杂因素和评估结果。结果：在94,840例MINOCA患者中，28,270例（30%）患有房颤。房颤与较高的住院死亡率（3.74%对2.75%,p=0.004）和急性心力衰竭（38.33%对34.97%,p0.050）相关。结论：MINOCA患者房颤与较差的住院预后相关，包括死亡率、心力衰竭、急性肾损伤和心源性休克。房颤可能是这一人群的关键预后指标，值得进一步研究。

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

Critical Pathways in Cardiology Medicine-Medicine (all)

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Critical Pathways in Cardiology provides a single source for the diagnostic and therapeutic protocols in use at hospitals worldwide for patients with cardiac disorders. The Journal presents critical pathways for specific diagnoses—complete with evidence-based rationales—and also publishes studies of these protocols" effectiveness.