Key result
New-onset atrial fibrillation in acute myocardial infarction patients was associated with the highest in-hospital mortality compared to other types of atrial fibrillation (p < 0.001).
Why the study?
Although AF in AMI can worsen prognosis, it remains unclear whether new-onset AF is a more aggravating diagnosis than other types of pre-existing AF.
Does new-onset atrial fibrillation worsen in-hospital outcomes in acute myocardial infarction patients compared to pre-existing or no atrial fibrillation?
Cohort (n=954)
No
Does new-onset atrial fibrillation worsen in-hospital outcomes in acute myocardial infarction patients compared to pre-existing or no atrial fibrillation?
p-value: p=<0.001
New-onset atrial fibrillation during acute myocardial infarction is associated with worse in-hospital outcomes and higher mortality compared to pre-existing AF or no AF.
(1) Background: Atrial fibrillation (AF) in acute myocardial infarction (AMI) could worsen the prognosis. Yet, there is no definitive answer to whether new-onset AF (NOAF) is a more aggravating diagnosis than other types of that arrhythmia. The purpose of our study was to compare in-hospital clinical course and outcomes of NOAF patients contrary to patients with other pre-existing types of AF. (2) Methods: AMI patients hospitalized in the high-volume cardiological center within 2017−2018 were included in the study. NOAF was noticed in 106 (11%) patients, 95 (10%) with an AF history and AF during AMI formed the AF group, 60 (6%) with an AF history but without AF during AMI constituted the Prior-AF group, and 693 (73%) patients were without an AF before and during AMI. Medical history, routinely monitored clinical parameters, and in-hospital outcomes were analyzed between the groups. (3) Results: NOAF patients, contrary to others, initially had the highest high-sensitivity troponin I (hsTnI), B-type natriuretic peptide (BNP), C-reactive protein (CRP), and glucose levels, and the lowest potassium concentration, with the worst profile of changes for that parameter within the first four days of hospitalization. NOAF patients had the highest rate of ST-elevated AMI (40%), the longest hospitalization (p < 0.001), and the highest in-hospital mortality (p < 0.001). Not NOAF, but other AF groups (AF and Prior-AF groups) were more burdened with the previous comorbidities. (4) Conclusions: NOAF could be a distinct phenomenon in AMI patients, identifying those with the worst clinical in-hospital course and outcomes as compared to other types of AF.
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Raczkowska-Golanko et al. (2022) conducted a cohort in Acute Myocardial Infarction (n=954). New-onset atrial fibrillation (NOAF) vs. Pre-existing atrial fibrillation or no atrial fibrillation was evaluated on In-hospital mortality (p=<0.001). New-onset atrial fibrillation in acute myocardial infarction patients was associated with the highest in-hospital mortality compared to other types of atrial fibrillation (p < 0.001).
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