In patients with acute STEMI, the incidence of new-onset atrial fibrillation was 9.3% with a pharmacoinvasive strategy and 9.2% with primary percutaneous coronary intervention.
Cohort (n=530)
Does a pharmacoinvasive strategy compared to primary PCI affect the incidence and outcomes of new-onset atrial fibrillation in patients with STEMI?
The incidence of new-onset atrial fibrillation in STEMI patients is similar whether managed with a pharmacoinvasive strategy or primary PCI, and is predicted by advanced age, hypertension, enlarged left atrium, elevated filling pressures, RCA culprit, and heart failure.
Absolute Event Rate: 9.3% vs 9.2%
Abstract Background Atrial fibrillation (AF) is a common arrhythmia and one of the complications in the setting of ST‐elevation myocardial infarction (STEMI). Our objective of the present study was to investigate the incidence, predictors, and outcomes of NOAF in patients with acute STEMI managed with pharmacoinvasive strategy (PIS) versus those managed with primary percutaneous coronary intervention (PPCI). Methods The study included 530 patients with STEMI divided into two groups according to the method of treatment. Group I: 269 patients subjected to pharmacoinvasive strategy (PIS), group II: 261 patients managed with primary percutaneous coronary intervention (PPCI). Incidence, predictors, and outcomes of NOAF were assessed in each group separately. Results The incidence of NOAF was 25 patients (9.3%) in group I and 24 patients (9.2%) in group II. Multivariate regression analysis identified the independent predictors of NOAF that were (advanced age ˃65 years, history of hypertension, left atrial volume index (LAVI) ˃34 ml/m 2 , E/e’ ratio ˃ 12, right coronary artery (RCA) as a culprit vessel and presence of heart failure). There was no statistically significant difference between both groups regarding the occurrence of MACE. Conclusion New‐onset AF represents one of the common complications in the setting of STEMI. Advanced age, hypertension, LAVI ˃34 ml/m 2 , E/e’ ratio ˃12, RCA culprit vessel, and heart failure were the independent predictors of NOAF.
Khalfallah et al. (Thu,) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=530). Pharmacoinvasive strategy (PIS) vs. Primary percutaneous coronary intervention (PPCI) was evaluated on Incidence of new-onset atrial fibrillation (NOAF). In patients with acute STEMI, the incidence of new-onset atrial fibrillation was 9.3% with a pharmacoinvasive strategy and 9.2% with primary percutaneous coronary intervention.