Occurrence of new-onset atrial fibrillation (AF) in the month following acute myocardial infarction (AMI) was found to be associated with elevated risks for death and ischemic stroke, according to a study published in Clinical Research in Cardiology.
Investigators obtained information for all patients with AMI who visited French hospitals between 2010 and 2019. Of 797,212 patients with AMI, 75,701 (9.5%; mean age, 80.0±10.0 years; 59.2% men) had a history of AF, and 34,768 (4.4%; mean age, 77.0±12.2 years; 58.7% men) had new-onset AF diagnosed in the 30-day period following AMI. Patients with new AF had fewer comorbidities than those with a history of AF.
During the follow-up period (mean, 1.8±2.4 years), 163,845 deaths and 30,672 ischemic strokes were recorded. Patients with a history of AF or new-onset AF were at higher risk for death during follow-up compared with those with no AF (adjusted hazard ratio [HR], 1.17; 95% CI, 1.16-1.19 and HR, 2.11; 95% CI, 2.07-2.15), according to a Cox multivariable analysis.
A history of AF and new-onset AF were associated with a higher risk for ischemic stroke compared no AF (HR, 1.19; 95% CI, 1.15-1.23 and HR, 1.78; 95% CI, 1.68-1.88, respectively). In addition, new AF was associated with a higher risk for death and ischemic stroke compared with a history of AF (HR, 1.74; 95% CI, 1.70-1.79 vs HR, 1.32; 95% CI, 1.23-1.42, respectively).
“In a large nationwide analysis, new AF recorded in the first 30 days after AMI was independently associated with higher risks [for] death, cardiovascular death, rehospitalization for heart failure, and ischemic stroke than those in patients with no AF or previously known AF,” noted the investigators.
The study is limited by its retrospective and observational nature as well as potential biases. In addition, the majority of the French population is Caucasian and results may not be generalizable to non-Caucasian populations.
“Strategies aiming at improving clinical outcomes are warranted for optimizing the prognosis of these patients with AMI and AF,” the study authors concluded.
Disclosures: Some of the authors reported affiliations with pharmaceutical and medical device companies. Please see the original reference for a full list of disclosures.
Fauchier L, Bisson A, Bodin A, et al. Outcomes in patients with acute myocardial infarction and new atrial fibrillation: A nationwide analysis [published online January 28, 2021]. Clin Res Cardiol. doi: 10.1007/s00392-021-01805-2