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Transient New-Onset Atrial Fibrillation Is Associated With Poor Clinical Outcomes in Patients With Acute Myocardial Infarction

Authors
 Jin Wi  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
Citation
 CIRCULATION JOURNAL, Vol.80(7) : 1615-1623, 2016 
Journal Title
 CIRCULATION JOURNAL 
ISSN
 1346-9843 
Issue Date
2016
MeSH
Aged ; Aged, 80 and over ; Atrial Fibrillation*/complications ; Atrial Fibrillation*/mortality ; Atrial Fibrillation*/physiopathology ; Atrial Fibrillation*/therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction*/complications ; Myocardial Infarction*/mortality ; Myocardial Infarction*/physiopathology ; Myocardial Infarction*/therapy ; Risk Factors
Keywords
Acute myocardial infarction ; Atrial fibrillation ; Major adverse cardiovascular event ; Mortality
Abstract
BACKGROUND: Atrial fibrillation (AF) is considered to be associated with poor clinical outcomes in patients with acute myocardial infarction (AMI). However, it remains uncertain whether transient new-onset AF (NOAF) during AMI has a subsequent increased risk of poor clinical outcomes. METHODS?AND?RESULTS: Transient NOAF was defined as AF that developed during AMI without a prior history and not documented for 1 month after discharge. The primary endpoints were major adverse cardiac events (MACE) and all-cause death. We enrolled 2,105 consecutive AMI patients. Overall, AF was observed in 209 (9.9%) and transient NOAF occurred in 102 (4.8%) among 150 patients (7.1%) with NOAF. The transient NOAF group showed higher 1-month (21.8 vs. 7.0%, P<0.001), 2-year (37.8 vs. 20.7%, P<0.001), and 5-year MACE rates (51.8 vs. 28.0%, P<0.001) than the group without AF. In-hospital (16.7 vs. 5.2%, P<0.001), 1-month (17.9 vs. 5.7%, P<0.001), 2-year (30.0 vs. 11.6%, P<0.001), and 5-year mortality rates (36.9 vs. 14.0%, P<0.001) were also higher in patients with transient NOAF. Transient NOAF was a significant independent predictor of both MACE (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.10-2.18, P=0.013) and death (HR 1.87, 95% CI 1.22-2.85, P=0.004). CONCLUSIONS: Transient NOAF was associated with the poorer clinical outcomes and was an important independent predictor of MACE and death in AMI patients.
Files in This Item:
T201602927.pdf Download
DOI
10.1253/circj.CJ-15-1250
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Wi, Jin(위진) ORCID logo https://orcid.org/0000-0003-0655-5130
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151835
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