Atrial fibrillation complicates acute myocardial infarction with an incidence of 6-21% and is associated with increased in-hospital and long-term mortality, as well as ischemic stroke risk.
Systematic Review
Does atrial fibrillation complicating acute myocardial infarction increase mortality and ischaemic stroke in patients hospitalized for AMI?
Atrial fibrillation is a frequent complication of acute myocardial infarction that significantly increases the risk of both short- and long-term mortality and ischaemic stroke, even if transient.
Atrial fibrillation (AF), the most commonly encountered clinical arrhythmia, often complicates acute myocardial infarction (AMI) with an incidence between 6 and 21%. Predictors of the arrhythmia in the setting of AMI include advanced age, heart failure symptoms, and depressed left ventricular function. The bulk of evidence demonstrates that AF in patients hospitalized for AMI has serious adverse prognostic implications regarding in-hospital, but also long-term mortality. This seems to apply for all patient populations studied without significant differences related to the treatment of AMI (i.e. no reperfusion therapy vs. thrombolysis vs. percutaneous coronary intervention). Mortality is particularly high in patients who have congestive heart failure and/or a reduced left ventricular ejection fraction. Finally, there are persuasive data indicating that AF complicating AMI not only increases the risk for ischaemic stroke during hospitalization but also during follow-up. This seems to apply also for transient AF which has reversed back to sinus rhythm at the time of discharge. These observations emphasize the need for prospective studies evaluating optimal therapeutic approaches for patients with AMI complicated by AF.
Schmitt et al. (Wed,) conducted a systematic review in Acute myocardial infarction complicated by atrial fibrillation. Atrial fibrillation (exposure) was evaluated on Incidence and prognostic implications of atrial fibrillation in acute myocardial infarction. Atrial fibrillation complicates acute myocardial infarction with an incidence of 6-21% and is associated with increased in-hospital and long-term mortality, as well as ischemic stroke risk.