Key result
Atrial fibrillation was the direct cause of myocardial infarction in 9.8% of patients, and AF-triggered type 2A MI had lower 30-day mortality than other triggers (6% vs. 11%).
Why the study?
The study was conducted to evaluate the incidence and prognosis of type 1 and type 2 myocardial infarction in patients with acute myocardial infarction and known AF, aiming to identify MI directly linked to AF.
Observational (n=665)
Only about 10% of myocardial infarctions in patients with known atrial fibrillation are directly caused by the arrhythmia, mostly presenting as type 2 MI with lower 30-day mortality than other triggers.
Answers are grounded in this paper and cite their sources.
AF may directly precipitate MI in known cases; leaves open whether targeted rhythm control alters incidence or prognosis.
The aim of the study was to evaluate the incidence and prognosis of type 1 myocardial infarction (T1MI) and type 2 MI (T2MI) in patients with acute MI and known atrial fibrillation (AF) to identify MI directly linked to AF. Among the 669 patients, four patients with hyperthyroidism were excluded, and among the remaining 665 patients, about two-thirds were diagnosed with T1MI, and the remaining third were diagnosed with T2MI. AF was the direct cause of MI in 9.8% of our overall population [1.8% of T1MI type C (coronary embolism), 4.9% of T2MI type A and 3.1% of T2MI type B]. Among patients with T2MI, 30-day mortality was lower when the trigger was AF than for the other triggers, for both type 2A (6% vs. 11%) and type 2B (0% vs. 13%). Most cases of AF-related MI are, thus, T2MI, for which therapeutic guidelines are lacking. Given the diverse triggers in T2MI, a specific approach using etiological patterns is needed to properly determine the optimal therapeutic.
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Putot et al. (2022) conducted an observational in Acute myocardial infarction and known atrial fibrillation (n=665). Atrial fibrillation as a direct trigger of MI vs. Other triggers of MI was evaluated on Incidence of MI directly linked to AF. Atrial fibrillation was the direct cause of myocardial infarction in 9.8% of patients, and AF-triggered type 2A MI had lower 30-day mortality than other triggers (6% vs. 11%).
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