Why the study?
AF is the most frequent supraventricular arrhythmia in AMI and worsens outcomes, yet managing both conditions is challenging due to the increased bleeding risk of triple antithrombotic therapy.
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This review highlights the complex interplay, shared pathophysiology, and significant management challenges—particularly regarding antithrombotic therapy—in patients with concurrent atrial fibrillation and acute myocardial infarction.
Atrial fibrillation is the most frequently occurring supraventricular arrhythmia in patients presenting with acute myocardial infarction. It is associated with worse outcomes when it coexists with acute myocardial infarction and results in increased morbidity and mortality. Both conditions are closely related to each other and share similar pathophysiological pathways. The management of atrial fibrillation in patients with acute myocardial infarction is challenging since triple antithrombotic therapy is indicated, but this results in a markedly increased risk of bleeding events and mortality. This review addresses the interactions between both conditions including common risk factors, possible mechanisms through which acute myocardial infarction contributes to development of atrial fibrillation and vice versa, and the problem of using anticoagulation in the management of these patients.
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El-Shetry et al. (2021) studied this question.
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