Key result
Incident atrial fibrillation occurring 24 to 72 hours after admission for STEMI was associated with a significantly higher 30-day mortality compared to patients without atrial fibrillation (OR 11.515).
Why the study?
Does the timing of incident atrial fibrillation onset affect 30-day mortality in patients with STEMI undergoing primary PCI?
Cohort (n=830)
Yes
Does the timing of incident atrial fibrillation onset affect 30-day mortality in patients with STEMI undergoing primary PCI?
New-onset atrial fibrillation occurring within the first 72 hours of admission for STEMI is a strong predictor of 30-day mortality, whereas AF occurring after 72 hours does not appear to carry the same short-term mortality risk.
May warrant closer monitoring for delayed AF post-STEMI; leaves open whether targeted intervention improves survival.
Atrial fibrillation (AF) is associated with short-term mortality after ST-elevation myocardial infarction (STEMI), but there is limited data on the temporal association between AF and mortality after STEMI. A total of 830 patients were included (age: 62 ± 12 years, 76 % male). Patients with new-onset AF < 30 days after STEMI were divided among three subgroups: AF on the day of admission, AF 24-72 h and AF > 72 h after admission. Thirty-day mortality was assessed by telephone and via the municipal population registry. Twenty patients died < 30 days after admission. In 41 patients, AF was detected on the day of admission, in 14 patients 24-72 h after admission and in 18 patients > 72 h after admission. Mortality was higher in patients with AF on the day of admission (7.3 vs 2.2 %, p = 0.036) and 24-72 h after admission (14.3 vs 1.4 %, p < 0.001), but not in patients with AF > 72 h after admission (0 vs 1.1 %, p > 0.999). Age (odds ratio (OR) 1.123, p < 0.001), Killip class (adjusted OR 8.341, p < 0.001), AF on the day of admission (OR 3.585, p = 0.049) and 24-72 h after admission (OR 11.515, p = 0.003) were, amongst other variables, associated with an increased 30-day mortality. In conclusion, only new-onset incident AF during the first 72 h after admission was associated with 30-day mortality in STEMI patients.
No takes yet. Share an insight, caveat, or question.
Gal et al. (2015) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=830). Incident atrial fibrillation 24-72 hours after admission vs. No atrial fibrillation was evaluated on 30-day all-cause mortality (OR 11.515, 95% CI 2.300-57.662, p=0.003). Incident atrial fibrillation occurring 24 to 72 hours after admission for STEMI was associated with a significantly higher 30-day mortality compared to patients without atrial fibrillation (OR 11.515).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: