Key result
Atrial fibrillation was independently associated with a 39% increased risk of myocardial infarction compared to non-atrial fibrillation patients in adjusted models (RR 1.39).
Why the study?
Does atrial fibrillation increase the risk of myocardial infarction, cardiovascular death, and cardiovascular events in adult patients?
Systematic Review and Meta-Analysis (n=1,324,037)
Does atrial fibrillation increase the risk of myocardial infarction, cardiovascular death, and cardiovascular events in adult patients?
Atrial fibrillation is an independent risk factor for myocardial infarction, cardiovascular death, and cardiovascular events, highlighting the need for comprehensive cardiovascular risk management beyond stroke prevention.
AF predicts higher MI and CV death risk in observational data; leaves open causality and need for prospective trials.
This study aimed to investigate whether atrial fibrillation (AF) predicts myocardial infarction (MI) or cardiovascular (CV) death. AF is a well-established risk factor for thrombotic stroke and all-cause mortality. PubMed, EmBase, and Cochrane Central were searched for articles comparing the incidence rates of MI, CV death, or CV events between AF and non-AF patients. Relative risk ratio (RR) was used as effect estimate. Crude and adjusted RRs were calculated. Data were pooled using a random-effects model. The meta-analysis included 27 studies. In the unadjusted analysis, AF patients had a nonsignificant trend toward a higher risk of MI compared with non-AF patients; however, a significant association was found. The crude data analysis showed that AF was associated with increased risk of CV death (P < 0.05) and CV events (P < 0.05). These associations remained significant after pooling data from adjusted models (CV death: RR = 1.95, 95% CI 1.51-2.51, P < 0.05; CV events: RR = 2.10, 95% CI 1.50-2.95, P < 0.05). These results showed that AF is an independent risk factor for MI, CV death, and CV events.
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He et al. (2017) conducted a systematic review and meta-analysis in Atrial fibrillation (n=1,324,037). Atrial fibrillation vs. Non-atrial fibrillation was evaluated on Myocardial infarction (adjusted models) (RR 1.39, 95% CI 1.05-1.85, p=<0.05). Atrial fibrillation was independently associated with a 39% increased risk of myocardial infarction compared to non-atrial fibrillation patients in adjusted models (RR 1.39).
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