Key result
Late new-onset atrial fibrillation (>48 hours) in acute coronary syndrome was associated with higher in-hospital mortality (14.2% vs 9.6%) and 1-year mortality compared to early onset (<48 hours).
Why the study?
The clinical impact of the timing of new-onset atrial fibrillation in the setting of acute coronary syndrome remains debatable.
Does the timing of new-onset atrial fibrillation (early vs late) affect mortality and cardiac events in patients with acute coronary syndromes?
Observational (n=944)
Yes
Does the timing of new-onset atrial fibrillation (early vs late) affect mortality and cardiac events in patients with acute coronary syndromes?
Absolute Event Rate: 14.2% vs 9.6%
p-value: p=0.031
In patients with acute coronary syndromes, late new-onset atrial fibrillation (>48 hours) is associated with worse 1-year mortality and readmission, while early new-onset AF is associated with more in-hospital complications.
Early nAF in ACS may signal higher risk than later onset; hypothesis-generating, prospective data needed before timing guides care.
Background: In a stressful situation like acute coronary syndrome (ACS), the occurrence of the first episode of atrial fibrillation is more frequent. The impact of the timing occurrence of AF new-onset (nAF) in the setting of ACS is still debatable. Methods: Multicenter retrospective study based on the Acute Coronary Syndrome Portuguese National Registry, including 29 851 patients admitted for ACS between 1/10/2010 and 4/09/2019. The group with early nAF - nAF in the first 48 h of hospitalization; and late nAF - patients with nAF after the first 48 h of in-hospital admission. Results: New-onset AF was identified in 1067 patients, nonetheless, just 38.1% had late nAF. The group with late nAF presented more cardiovascular comorbidities and worse left ventricular ejection fraction. Late nAF patients received more anti-arrhythmic therapy, and early nAF had a higher beta-block prescription. Early nAF had higher rates of in-hospital complications, on the other hand, late nAF group exhibited more mortality and readmission at one year follow-up. Multiple logistic regression revealed that symptoms onset to the first medical contact time, admission hemoglobin <12 g/dl, right bundle branch block at admission, and diuretic therapy during the hospitalization for ACS were predictors of late nAF in ACS. Conclusions: The ACS population could be divided by the timing of nAF occurrence into the two groups with different characteristics, therapeutic approaches, and outcomes. Late nAF patients had a worse prognosis at 1 year follow-up, however, the early nAF group had more major adverse cardiac events during the hospitalization for ACS.
No takes yet. Share an insight, caveat, or question.
Santos et al. (2022) conducted an observational in Acute Coronary Syndrome with new-onset Atrial Fibrillation (n=944). Late new-onset atrial fibrillation (>48 hours) vs. Early new-onset atrial fibrillation (<48 hours) was evaluated on In-hospital mortality (p=0.031). Late new-onset atrial fibrillation (>48 hours) in acute coronary syndrome was associated with higher in-hospital mortality (14.2% vs 9.6%) and 1-year mortality compared to early onset (<48 hours).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: