Do baseline atrial electrocardiographic and infarction patterns predict new-onset atrial fibrillation after ST-elevation myocardial infarction? Insights from the Assessment of Pexelizumab in Acute Myocardial Infarction Trial.

Journal Article (Clinical Trial;Journal Article)

BACKGROUND: Atrial infarction reportedly occurs in 0.7% to 52% of ST-elevation myocardial infarctions (STEMIs), up to two thirds of whom develop atrial fibrillation and flutter (AF). Prospective validation of electrocardiographic atrial infarction patterns is lacking. Hence, in STEMI patients treated with primary percutaneous coronary intervention, we examined whether baseline atrial electrocardiographic changes or atrial infarction patterns predicted new AF or mortality. METHODS: Within the Assessment of Pexelizumab in Acute Myocardial Infarction trial, a nested case-control study was conducted. Patients with new AF were matched 1:1 with controls, and baseline atrial electrocardiographic variables were examined. RESULTS: Abnormal P wave morphology (Liu minor criterion for atrial infarction) was significantly associated with new AF (adjusted odds ratio, 1.68; 1.03-2.73). This was also independently associated with 90-day mortality in the overall case-control cohort (adjusted hazard rate, 1.90; 1.04-3.46) and among patient with new-onset AF (adjusted hazard rate, 2.43; 1.22-4.84). CONCLUSIONS: Abnormal P wave morphology significantly predicted new AF and 90-day mortality in STEMI patients.

Full Text

Duke Authors

Cited Authors

  • van Diepen, S; Siha, H; Fu, Y; Westerhout, CM; Lopes, RD; Granger, CB; Armstrong, PW; APEX AMI Investigators,

Published Date

  • 2010

Published In

Volume / Issue

  • 43 / 4

Start / End Page

  • 351 - 358

PubMed ID

  • 20444469

Electronic International Standard Serial Number (EISSN)

  • 1532-8430

Digital Object Identifier (DOI)

  • 10.1016/j.jelectrocard.2010.04.001


  • eng

Conference Location

  • United States