Key result
Fasting hyperglycemia was independently associated with a significantly higher risk of new-onset atrial fibrillation (OR 2.56) compared to normal fasting glucose in patients with acute myocardial infarction.
Why the study?
The relationship between fasting hyperglycemia and new-onset AF in AMI patients was unclear, and whether their co-occurrence worsens prognosis compared with either alone was unknown.
Does fasting hyperglycemia increase the risk of new-onset atrial fibrillation and mortality in patients with acute myocardial infarction?
Cohort (n=563)
No
Does fasting hyperglycemia increase the risk of new-onset atrial fibrillation and mortality in patients with acute myocardial infarction?
Odds Ratio: 2.56 (95% CI 1.53–4.3)
Absolute Event Rate: 21.6% vs 9.2%
p-value: p=<0.001
In patients with acute myocardial infarction, fasting hyperglycemia is an independent risk factor for new-onset atrial fibrillation, and their combination significantly increases long-term all-cause mortality.
May inform AF risk stratification via fasting glucose post-AMI; leaves open causal effects and intervention benefits.
Background: The relationship between fasting hyperglycemia (FHG) and new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI) is unclear, and whether their co-occurrence is associated with a worse in-hospital and long-term prognosis than FHG or AF alone is unknown. Objective: To explore the correlation between FHG and new-onset AF in patients with AMI, and their impact on in-hospital and long-term all-cause mortality. Methods: We performed a retrospective cohort study comprising 563 AMI patients. The patients were divided into the FHG group and the NFHG group. The incidence of new-onset AF during hospitalization was compared between the two groups and sub-groups under different Killip grades. Logistic regression was used to assess the association between FHG and new-onset AF. In-hospital mortality and long-term all-cause mortality were compared among patients with FHG, AF, and with both FHG and AF according to 10 years of follow-up information. Results: New-onset AF occurred more frequently in the FHG group than in the NFHG group (21.6 vs. 9.2%, p < 0.001). This trend was observed for Killip grade I (16.6 vs. 6.5%, p = 0.002) and Grade II (17.1 vs. 6.9%, p = 0.005), but not for Killip grade III–IV (40 vs. 33.3%, p = 0.761). Logistic regression showed FHG independently correlated with new-onset AF (OR, 2.56; 95% CI, 1.53–4.30; P < 0.001), and 1 mmol/L increased in fasting glucose was associated with a 5% higher rate of new-onset AF, after adjustment for traditional AF risk factors. AMI patients complicated with both fasting hyperglycemia and AF showed the highest in-hospital mortality and long-term all-cause mortality during an average of 11.2 years of follow-up. Multivariate Cox regression showed FHG combined with AF independently correlated with long-term all-cause mortality after adjustment for other traditional risk factors (OR = 3.13, 95% CI 1.64–5.96, p = 0.001), compared with the group with neither FHG nor new-onset AF. Conclusion: FHG was an independent risk factor for new-onset AF in patients with AMI. AMI patients complicated with both FHG and new-onset AF showed worse in-hospital and long-term all-cause mortality than with FHG or AF alone.
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Li et al. (2021) conducted a cohort in Acute Myocardial Infarction (n=563). Fasting hyperglycemia (≥7 mmol/L) vs. No fasting hyperglycemia (<7 mmol/L) was evaluated on New-onset atrial fibrillation during hospitalization (OR 2.56, 95% CI 1.53-4.30, p=<0.001). Fasting hyperglycemia was independently associated with a significantly higher risk of new-onset atrial fibrillation (OR 2.56) compared to normal fasting glucose in patients with acute myocardial infarction.
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