Key result
New-onset atrial fibrillation during acute coronary syndrome was associated with higher long-term mortality compared to no atrial fibrillation (36.4% vs 11.8%; OR 4.29; 95% CI 1.08-14.62; p=0.033).
Why the study?
To evaluate the predictive significance of clinical, instrumental, and laboratory parameters regarding mortality at long-term follow-up in patients with ACS and AF.
Cohort (n=67)
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New-onset atrial fibrillation, anemia, female sex, and elevated biomarkers (NT-proBNP, CRP) are significant predictors of long-term mortality in patients following acute coronary syndrome.
The aim — to evaluate the predictive significance of clinical, instrumental and laboratory parameters regarding the mortality of patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) at long‑term follow‑up (over 2 years).Materials and methods. We examined 125 patients with ACS. In 26 (18; 40) months, the information regarding the vital status was collected. The data was available for 67 patients. 22 (32.8 %) of them developed new‑onset AF during the acute disease phase; 11 (16.4 %) had AF before ACS; 34 (50.8 %) had no signs of AF in their medical history and during hospitalization. Blood samples for determination of N‑terminal fragment of brain natriuretic peptide (NT‑proBNP) were taken during the first 24 hours of the disease by enzyme immunoassay.Results and discussion. 14 patients died during the follow‑up period, the mortality rate was 20.9 %. Mortality in patients who developed new‑onset AF on the background of ACS was higher than mortality in patients without AF (36.4 % vs 11.8 %, respectively; р = 0.033); odds ratio was 4.29 (95 % confidence interval — 1.08 — 14.62). Mortality in men was 12.5 %, in women — 33.3 % (р = 0.040). Percentage of smokers was statistically significantly higher in patients who survived (р = 0.007). Prevalence of anemia was 11.3 % in patients who survived and 57.1 % in patients who died (р = 0.0001). Patients who died had higher levels of NT‑proBNP (р = 0.016), glycemia (р = 0.008) and C‑reactive protein (р = 0.005) at admission. ROC‑analysis showed that the risk of death was associated with red blood cell count ≤ 4.09 · 1012/l (р = 0.0004), hemoglobin level ≤ 117 g/l (р = 0.0008), glycemia > 6.6 mmol/l (р = 0.002), C‑reactive protein > 24 mg/l (р = 0.0008), NT‑proBNP > 1788 pg/ml (р < 0.0001).Conclusions. Mortality of patients after ACS at 26 (18; 40) month follow‑up was 20.9 %. Mortality in patients who developed new‑onset AF on the background of ACS was 36.4 %, which was statistically significantly higher than mortality in patients without AF. Female patients, patients with anemia and non‑smokers were more likely to die. ROC‑analysis established laboratory test indices associated with the death risk.
Tseluyko et al. (2019) conducted a cohort in Acute coronary syndrome and atrial fibrillation (n=67). New-onset atrial fibrillation vs. No atrial fibrillation was evaluated on Mortality (OR 4.29, 95% CI 1.08-14.62, p=0.033). New-onset atrial fibrillation during acute coronary syndrome was associated with higher long-term mortality compared to no atrial fibrillation (36.4% vs 11.8%; OR 4.29; 95% CI 1.08-14.62; p=0.033).