Key result
New-onset atrial fibrillation during acute coronary syndrome was associated with significantly higher hospital mortality compared to sinus rhythm (14.29% vs 3.7%, p=0.0038).
Why the study?
Does new-onset atrial fibrillation worsen mortality and bleeding outcomes in patients with acute coronary syndrome compared to sinus rhythm?
Cohort (n=239)
Yes
Does new-onset atrial fibrillation worsen mortality and bleeding outcomes in patients with acute coronary syndrome compared to sinus rhythm?
Patients who develop atrial fibrillation during an acute coronary syndrome have a significantly higher risk of hospital and mid-term mortality, as well as an increased risk of stroke and bleeding.
OBJECTIVE: to analyze patients with first-time developing atrial fibrillation (AF), against acute coronary syndrome (ACS), risk factors for arrhythmia, assessment of patients' adherence to oral anticoagulant therapy 6-24 months after the ACS episode, according to the total ACS registry for the Krasnodar Territory. MATERIALS AND METHODS: A retrospective analysis of the case histories of 13,244 patients admited to the infarction departments of all setlements of the Krasnodar Territory without exception and included in the ACS registry for the Krasnodar Territory from November 20, 2015 to January 20, 2018. RESULTS: The study group of ACS with AF included 201 patients, among them 144 men (71.642%), women 57 (28.358%). The average age was 68,084 ± 9,606 years, a maximum of 85 years, a minimum of 25 years. The frequency of the following outcomes was assessed: hospital mortality, frequency of hemorrhagic, thromboembolic complications. The effectiveness of prognostic scales of development of hemorrhage CRUSADE and HAS BLED was evaluated and the expediency of prescribing extended OAT to patients with the first developed AF atack against the background of ACS after discharge from the hospital. CONCLUSIONS: Based on the obtained results, based on the data of the total ACS register for the Krasnodar Territory, we can conclude: 1. Patients with a newly developed episode of AF on the background of ACS have demographic, anamnestic data comparable with other types of AF; 2. Patients with a newly developed AF episode on the background of ACS have a more severe course of the disease, which does not affect hospital mortality, hospital complications and lethality after 6-24 months after discharge from the hospital for ACS; 3. Patients with a newly developed episode of AF on the background of ACS after discharge from the hospital do not have arrhythmia recurrences, they do not have thromboembolic complications. The decision on the duration of oral anticoagulant therapy should be carried out afer carrying out a multi-day monitoring of the ECG.
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Татаринцева et al. (2018) conducted a cohort in Acute coronary syndrome (n=239). New-onset atrial fibrillation vs. Sinus rhythm was evaluated on Hospital mortality (p=0.0038). New-onset atrial fibrillation during acute coronary syndrome was associated with significantly higher hospital mortality compared to sinus rhythm (14.29% vs 3.7%, p=0.0038).
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