Why the study?
Acute STEMI and new-onset AF are associated with increased mortality, prompting evaluation of the incidence of new-onset AF following primary versus delayed PCI and associated risk factors.
Does primary percutaneous coronary intervention reduce the incidence of new-onset atrial fibrillation in patients with acute STEMI compared to delayed percutaneous coronary intervention?
Does primary percutaneous coronary intervention reduce the incidence of new-onset atrial fibrillation in patients with acute STEMI compared to delayed percutaneous coronary intervention?
Primary PCI, compared to delayed PCI, is associated with a significantly lower risk of developing new-onset atrial fibrillation within 3 months following an acute STEMI.
Primary PCI associated with lower new-onset AF risk after STEMI; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Acute ST-segment elevation myocardial infarction (STEMI) and new-onset atrial fibrillation (AF) are associated with increased risk of mortality. HYPOTHESIS: This study aimed to determine the proportion of patients who go on to develop new-onset a AF after undergoing a primary or delayed percutaneous coronary intervention (PCI) for an acute STEMI and to explore possible risk factors. METHODS: One hundred and fifty-four patients who underwent PCI after STEMI were included in the study. Patient characteristics, baseline blood tests and cardiac parameters, type of PCI, and incidence of new-onset AF within 3 months of PCI were recorded and analyzed. RESULTS: Fifteen developed new-onset AF following the PCI, and 139 patients maintained a sinus rhythm. Univariate analysis showed significant differences between the two patient groups in terms of age, nature of the PCI (primary vs. delayed), left atrial diameter, and left ventricular diastolic dysfunction (p < .05). Age (odds ratio [OR] = 1.065, 95% confidence interval [CI]: 1.007-1.127, p < .05) and left atrial diameter (OR = 1.165, 95% CI: 1.008-1.347, p < .05), were independent predictors of new-onset AF after PCI. Primary PCI (OR = 0.232, 95% CI: 0.066-0.814, p < .05) was an independent protective factor. CONCLUSION: Age and left atrial diameter were independent risk factors of new-onset AF in patients undergoing a PCI following an acute myocardial infarction, while primary PCI was a protective factor. This discovery can help reduce mortality rate, improve long-term prognosis, and provide a theoretical basis for the prevention of new-onset AF.
No takes yet. Share an insight, caveat, or question.
Pan et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: