Key result
New-onset atrial fibrillation after primary PCI was associated with a higher risk of 30-day major adverse cardiovascular events compared to patients without AF (adjusted OR 2.39; 95% CI 1.47-3.87).
Why the study?
Does new-onset atrial fibrillation after primary percutaneous coronary intervention increase the risk of 30-day major adverse cardiovascular events?
Cohort (n=2,096)
Does new-onset atrial fibrillation after primary percutaneous coronary intervention increase the risk of 30-day major adverse cardiovascular events?
Odds Ratio: 2.39 (95% CI 1.47–3.87)
New-onset atrial fibrillation after primary PCI is a significant predictor of adverse 30-day outcomes, including increased mortality and major adverse cardiovascular events.
May inform post-PCI risk stratification; leaves open whether new-onset AF is a modifiable target.
OBJECTIVES: Limited data exist about the prognostic significance of new-onset atrial fibrillation (AF) after contemporary primary percutaneous coronary intervention (pPCI). The objective of this study was to identify the incidence and predictors of new-onset AF and associated adverse 30-day outcomes in AF patients who underwent pPCI. METHODS: We analyzed 2096 patients undergoing pPCI after pretreatment with 600 mg clopidogrel. Composite 30-day major adverse cardiovascular events were the primary end point. A logistic regression model was developed to identify risk factors for the occurrence of AF and prediction of its impact on 30-day outcomes. RESULTS: AF occurred in 6.2% of patients. Older age, Killip >1 heart failure at admission, systolic blood pressure of greater than 100 mmHg at admission, creatinine clearance greater than 60 ml/min, preprocedural infarction-related artery occlusion and postprocedural thrombolysis in myocardial infarction flow less than 3 were identified as independent predictors of the occurrence of AF. Rates of 30-day major adverse cardiovascular events [adjusted odds ratio (OR) 2.39, 95% confidence interval (CI): 1.47-3.87] and 30-day death (adjusted OR 2.67, 95% CI: 1.46-4.89) were higher in AF patients compared with patients without AF. A trend toward higher rate of ischemia-driven target vessel revascularization was observed in the AF group (adjusted OR 2.61, 95% CI: 0.82-8.39, P=0.10). CONCLUSION: New-onset AF after pPCI is associated with adverse 30-day outcomes. Accurate prediction of AF after pPCI might help deciding a more aggressive treatment approach aimed at preventing the adverse prognosis of these patients.
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Mrdović et al. (2011) conducted a cohort in Primary percutaneous coronary intervention (n=2,096). New-onset atrial fibrillation vs. Patients without atrial fibrillation was evaluated on Composite 30-day major adverse cardiovascular events (OR 2.39, 95% CI 1.47-3.87). New-onset atrial fibrillation after primary PCI was associated with a higher risk of 30-day major adverse cardiovascular events compared to patients without AF (adjusted OR 2.39; 95% CI 1.47-3.87).
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