The risk of stroke after acute myocardial infarction in patients with and without atrial fibrillation: A nationwide cohort study

Figures

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  Fig. 1. Flowchart outlining the various study cohorts. There were 186 326 patients in Taiwan between January 2000 and December 2012 with the first diagnosis of AMI. From this group, patients who were ≤20 or ≥120-years old, who had doubtful data, who had the diagnoses of both STEMI and NSTEMI, and who had the history of stroke were excluded, leaving 170 472 patients. Among these 170 472 patients, 8350 patients had AF in discharge diagnosis. In the other 161 942 patients without AF in discharge diagnosis, patients with AF diagnosis before admission were excluded. The final 158 046 patients underwent one-to-one propensity score matching to minimize baseline differences between the two groups. Patients with AF in discharge diagnosis were further divided into newly diagnosed AF or pre-existing AF. AF = atrial fibrillation; AMI = acute myocardial infarction; NSTEMI = non-ST-elevated myocardial infarction; STEMI = ST-elevated myocardial infarction; TIA = transient ischemic attack.

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  Fig. 2. Kaplan–Meier curve for stroke after the first AMI for all patients and sex subgroups. Overall, the stroke rates were higher in the AF group (A, log-rank p < 0.0001), in the male subgroup (B, log-rank p < 0.0001) and in the female subgroup (C, log-rank p < 0.0001). AF = atrial fibrillation; AMI = acute myocardial infarction.

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  Fig. 3. Kaplan–Meier curve of stroke after the first AMI for age subgroups. Overall, the stroke rates were higher in AF patients in the “age <65 years” subgroup (A, log-rank p < 0.0001), in the “age ≥65 years and <75 years” subgroup (B, log-rank p < 0.0001), and in the “age ≥75 years” subgroup (C, log-rank p < 0.0001). AF = atrial fibrillation; AMI = acute myocardial infarction.

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  Fig. 4. Kaplan–Meier curve of stroke after the first AMI for interventional therapy subgroups. Overall, the stroke rates were higher in the “without interventional therapy” subgroup (A, log-rank p < 0.0001) and in the “with interventional therapy” subgroup (B, log-rank p < 0.0001). AF = atrial fibrillation; AMI = acute myocardial infarction.

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  Fig. 5. Forest plot of HR and p for interaction for various characteristics in patients with or without AF during admission. AF = atrial fibrillation; HR = hazard ratios.