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Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation.

Publication ,  Journal Article
Lopes, RD; Pieper, KS; Horton, JR; Al-Khatib, SM; Newby, LK; Mehta, RH; Van de Werf, F; Armstrong, PW; Mahaffey, KW; Harrington, RA; Ohman, EM ...
Published in: Heart
July 2008

OBJECTIVE: To assess variables associated with the occurrence of atrial fibrillation (AF) and the relation of AF with short- and long-term outcomes and with other in-hospital complications in patients with acute coronary syndromes (ACS) with and without ST-segment elevation. DESIGN: Pooled database of 120 566 patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation (NSTE) ACS enrolled in 10 clinical trials. Multivariable logistic regression and Cox proportional hazards modelling were used to identify factors associated with AF and its relation with clinical outcomes. SETTING: ACS complicated by AF. PATIENTS: 120,566 patients with STEMI and NSTE-ACS in 10 clinical trials. INTERVENTIONS: None evaluated. MAIN OUTCOME MEASURE: Short- and long-term mortality. RESULTS: Occurrence of AF was 7.5% in the overall population (STEMI 8.0% (n = 84 161); NSTE-ACS = 6.4% (n = 36,405)). Seven-day mortality was higher for patients with AF (5.1%) than for those without (1.6%). After adjusting for confounders, association of AF with 7-day mortality was present in STEMI (hazards ratio (HR) = 1.65; 95% CI 1.44 to 1.90) and NSTE-ACS (HR = 2.30; 95% CI 1.83 to 2.90; p interaction = 0.015). Risk of long-term mortality (day 8 to 1 year) was also higher in STEMI (HR = 2.37; 95% CI 1.79 to 3.15) and NSTE-ACS (HR = 1.67; 95% CI 1.41 to 1.99). AF had a larger impact in NSTE-ACS on risk of short-term mortality (p<0.001), stroke (p<0.001), ischaemic stroke (p<0.001) and moderate or severe bleeding (p<0.001). CONCLUSIONS: AF is more common in patients with STEMI. An association of AF with short- and long-term mortality among patients with STEMI and NSTE-ACS was found. Understanding these findings may lead to better care of patients with this common arrhythmia.

Duke Scholars

Published In

Heart

DOI

EISSN

1468-201X

Publication Date

July 2008

Volume

94

Issue

7

Start / End Page

867 / 873

Location

England

Related Subject Headings

  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • Female
  • Epidemiologic Methods
  • Electrocardiography
  • Cardiovascular System & Hematology
 

Citation

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Chicago
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Lopes, R. D., Pieper, K. S., Horton, J. R., Al-Khatib, S. M., Newby, L. K., Mehta, R. H., … Granger, C. B. (2008). Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart, 94(7), 867–873. https://doi.org/10.1136/hrt.2007.134486
Lopes, R. D., K. S. Pieper, J. R. Horton, S. M. Al-Khatib, L. K. Newby, R. H. Mehta, F. Van de Werf, et al. “Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation.Heart 94, no. 7 (July 2008): 867–73. https://doi.org/10.1136/hrt.2007.134486.
Lopes RD, Pieper KS, Horton JR, Al-Khatib SM, Newby LK, Mehta RH, et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart. 2008 Jul;94(7):867–73.
Lopes, R. D., et al. “Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation.Heart, vol. 94, no. 7, July 2008, pp. 867–73. Pubmed, doi:10.1136/hrt.2007.134486.
Lopes RD, Pieper KS, Horton JR, Al-Khatib SM, Newby LK, Mehta RH, Van de Werf F, Armstrong PW, Mahaffey KW, Harrington RA, Ohman EM, White HD, Wallentin L, Granger CB. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart. 2008 Jul;94(7):867–873.

Published In

Heart

DOI

EISSN

1468-201X

Publication Date

July 2008

Volume

94

Issue

7

Start / End Page

867 / 873

Location

England

Related Subject Headings

  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • Female
  • Epidemiologic Methods
  • Electrocardiography
  • Cardiovascular System & Hematology