Key result
New-onset AF in AMI is linked to ~354% higher in-hospital mortality.
Why the study?
New-onset atrial fibrillation is a significant complication of acute myocardial infarction, prompting investigation into whether routinely checked clinical parameters aid in its identification in modernly treated patients.
Do routine clinical parameters predict new-onset atrial fibrillation in patients with acute myocardial infarction?
Cohort (n=954)
No
Do routine clinical parameters predict new-onset atrial fibrillation in patients with acute myocardial infarction?
Routine clinical parameters including age ≥ 66 years, BNP ≥ 340 pg/mL, CRP ≥ 7.7 mg/L, and LVEF ≤ 44% can help identify AMI patients at high risk for new-onset atrial fibrillation, a complication associated with significantly increased in-hospital mortality.
Answers are grounded in this paper and cite their sources.
NOAF signals higher in-hospital mortality risk in AMI; hypothesis-generating for routine-parameter prediction without practice change.
(1) Background: New-onset atrial fibrillation (NOAF) is a significant complication of acute myocardial infarction (AMI). Our study aimed to investigate whether routinely checked clinical parameters aid in NOAF identification in modernly treated AMI patients. (2) Patients and methods: Patients admitted consecutively within 2017 and 2018 to the University Clinical Centre in Gdańsk (Poland) with AMI diagnosis (necrosis evidence in a clinical setting consistent with acute myocardial ischemia) were enrolled. Medical history and clinical parameters were checked during NOAF prediction. (3) Results: NOAF was diagnosed in 106 (11%) of 954 patients and was significantly associated with in-hospital mortality (OR 4.54, 95% CI 2.50–8.33, p < 0.001). Age, B-type natriuretic peptide (BNP), C-reactive protein (CRP), high-sensitivity troponin I, total cholesterol, low-density lipoprotein cholesterol, potassium, hemoglobin, leucocytes, neutrophil/lymphocyte ratio, left atrium size, and left ventricular ejection fraction (LVEF) were associated with NOAF in the univariate logistic analysis, whereas age ≥ 66 yo, BNP ≥ 340 pg/mL, CRP ≥ 7.7 mg/L, and LVEF ≤ 44% were associated with NOAF in the multivariate analysis. (4) Conclusions: NOAF is a multifactorial, significant complication of AMI, leading to a worse prognosis. Simple, routinely checked clinical parameters could be helpful indices of this arrhythmia in current invasively treated patients with AMI.
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Raczkowska-Golanko et al. (2021) conducted a cohort in Acute myocardial infarction (n=954). Routine clinical parameters (age, BNP, CRP, LVEF) was evaluated on In-hospital mortality associated with new-onset atrial fibrillation (OR 4.54, 95% CI 2.50-8.33, p=< 0.001). New-onset atrial fibrillation occurred in 11% of AMI patients and was significantly associated with increased in-hospital mortality (OR 4.54; 95% CI 2.50-8.33; p<0.001).
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