First-time detected atrial fibrillation during ACS admission was associated with increased 1-year risks of ischaemic stroke (HR 1.67; 95% CI 1.38-2.01) and mortality compared to patients without AF.
Cohort (n=161,266)
Yes
Does first-time detected atrial fibrillation during acute coronary syndrome increase the 1-year risk of ischaemic stroke, mortality, and bleeding compared to no AF or a history of AF?
First-time detected AF during an ACS admission is associated with at least as high a 1-year risk of ischaemic stroke, mortality, and bleeding as a prior history of AF.
Effect estimate: HR 1.67 (95% CI 1.38-2.01)
AIMS: The aim of this study was to examine contemporary data on the 1-year prognosis of patients surviving acute coronary syndrome (ACS) and concomitant first-time detected atrial fibrillation (AF). METHODS AND RESULTS: Using Danish nationwide registries, we identified all patients surviving a first-time admission with ACS from 2000 to 2018 and grouped them into (i) those without AF prior to or during ACS; (ii) those with a history of AF; and (iii) those with first-time detected AF during admission with ACS. With 1 year of follow-up, rates of ischaemic stroke, death, and bleeding were compared between study groups using multivariable adjusted Cox proportional hazards analysis. We included 161 266 ACS survivors: 135 878 (84.2%) without AF, 18 961 (11.8%) with history of AF, and 6427 (4.0%) with first-time detected AF at admission with ACS. Compared to those without AF, the adjusted 1-year rates of outcomes were as follows: ischaemic stroke hazard ratio (HR) 1.38 (95% CI 1.22-1.56) for patients with history of AF and HR 1.67 (95% CI 1.38-2.01) for patients with first-time detected AF; mortality HR 1.25 (95% CI 1.21-1.31) for patients with history of AF and HR 1.52 (95% CI 1.43-1.62) for patients with first-time detected AF; and bleeding HR 1.22 (95% CI 1.14-1.30) for patients with history of AF and HR 1.28 (95% CI 1.15-1.43) for patients with first-time detected AF. CONCLUSION: In patients with ACS, first-time detected AF appeared to be at least as strongly associated with the 1-year rates of ischaemic stroke, mortality, and bleeding as compared with patients with a history of AF.
Petersen et al. (Sat,) conducted a cohort in Acute coronary syndrome and atrial fibrillation (n=161,266). First-time detected atrial fibrillation vs. No atrial fibrillation was evaluated on Ischaemic stroke (HR 1.67, 95% CI 1.38-2.01). First-time detected atrial fibrillation during ACS admission was associated with increased 1-year risks of ischaemic stroke (HR 1.67; 95% CI 1.38-2.01) and mortality compared to patients without AF.