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June 12, 2026European Journal of Preventive CardiologyOpen Access

AF linked to ~39% higher MI risk in women but not men.

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Why the study?

Sex-specific risk patterns and the temporal relationship between AF and MI subtypes, including STEMI and NSTEMI, remain unclear.

Does incident atrial fibrillation increase the risk of myocardial infarction, STEMI, and NSTEMI differently by sex and time since diagnosis in a general population?

Population

25,132 participants without prevalent AF and MI at baseline in 1994-95

Comparison

Participants with AF vs participants without AF

Design

Population-based cohort study

Follow-up

1994-95 through 2021

Key result

Atrial fibrillation was associated with an increased hazard of myocardial infarction in women (sHR 1.39; 95% CI 1.12-1.72) but not in men, with risk patterns varying by time since diagnosis.

Authors

LNL NilsenESE SharashovaJMJ Mannsverk

Discussion

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Overview

AF may confer greater long-term MI risk in women than men; leaves open whether sex- or time-specific prevention alters outcomes.

Key Points

  • The aim is to explore sex-specific risks of myocardial infarction associated with atrial fibrillation and the influence of time since diagnosis.
  • Followed 25,132 participants from a population-based cohort study from 1994-95 through 2021.
  • Utilized Cox proportional and Fine-Gray subdistribution hazard regression to assess risk of MI, STEMI, and NSTEMI.
  • Evaluated risks based on time since AF diagnosis across various intervals.
  • AF was associated with increased hazard of MI in women (sHR 1.39, 95% CI 1.12–1.72) but not in men.
  • In women, hazard of MI peaked at ≥10 years since AF diagnosis (sHR 1.75, 95% CI 1.07–2.84).
  • In men, a significant hazard for STEMI was observed within the first six months (sHR 2.27, 95% CI 1.45–3.54).

Study Design

Type

Cohort (n=25,132)

Structured PICO

Does incident atrial fibrillation increase the risk of myocardial infarction, STEMI, and NSTEMI differently by sex and time since diagnosis in a general population?

P
Population
25,132 adults and elderly without prevalent atrial fibrillation and myocardial infarction at baseline, followed from 1994-95 through 2021.
E
Exposure
Incident atrial fibrillation (AF)
C
Comparator
Participants without atrial fibrillation
O
Outcome
Risk of total myocardial infarction (MI), STEMI, and NSTEMI overall and by time since AF diagnosishard clinical

Main Result

Hazard Ratio: 1.39 (95% CI 1.12–1.72)

The risk of myocardial infarction following an atrial fibrillation diagnosis exhibits distinct sex-specific temporal patterns, with women facing long-term NSTEMI risk and men facing short-term STEMI/NSTEMI risk.

Cite This Study

Nilsen et al. (2026) conducted a cohort in Atrial fibrillation and myocardial infarction (n=25,132). Atrial fibrillation vs. Participants without atrial fibrillation was evaluated on Myocardial infarction (MI) (sHR 1.39, 95% CI 1.12-1.72). Atrial fibrillation was associated with an increased hazard of myocardial infarction in women (sHR 1.39; 95% CI 1.12-1.72) but not in men, with risk patterns varying by time since diagnosis.

synapsesocial.com/papers/6a2bd11d6550ea4541ffe910https://doi.org/10.1093/eurjpc/zwag249.010
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Atrial fibrillation and risk of myocardial infarction by sex and time since diagnosis. The Tromsø Study 1994–20212026 · 1 citations
  2. 2Risk Factors, Subsequent Disease Onset, and Prognostic Impact of Myocardial Infarction and Atrial Fibrillation2022 · 18 citations
  3. 3Timing of New-Onset Atrial Fibrillation After Myocardial Infarction: Prognostic Impact and Associated Clinical Characteristics.2026
  4. 4Bidirectional Association Between Atrial Fibrillation and Myocardial Infarction, and Relation to Mortality in the Framingham Heart Study2024 · 4 citations
  5. 5Atrial Fibrillation and Myocardial Infarction: A Systematic Review and Appraisal of Pathophysiologic Mechanisms2016 · 202 citations