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Atrial Fibrillation on Admission Is Related With Higher Mortality in ST-Segment Elevation Myocardial Infarction Patients.

Abstract The prognostic significance of atrial fibrillation (AF) on mortality in ST-segment elevation myocardial infarction (STEMI) patients is not clearly understood. To elucidate the clinical significance of AF on mortality for 1 year in STEMI patients, we retrospectively analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) database, which spans January 2008 to September 2010 and includes 14,329 patients with acute myocardial infarction. We selected 5,556 patients with marked ECG rhythm (NSR, normal sinus rhythm or AF) on emergency room arrival, < 12 hours of symptom onset, and who underwent primary percutaneous coronary intervention (PCI) within 90 minutes of arriving at the hospital. Patients who had been followed-up for at least for 1 year were analyzed (2,636 of NSR, 119 of AF). At enrollment, AF patients were older (70.7 versus 65.5 years, P < 0.001) and had lower systolic blood pressure (120.6 versus 125.9 mmHg, P = 0.050), a higher heart rate (80.4 versus 75.6/minute, P = 0.009), and a higher rate of Killip III, IV (25.0 versus 14.2%, P = 0.002). Patients with AF showed clearly higher all-cause mortality (22.7 versus 9.5%, HR 2.51, 95%CI 1.68~3.76, P < 0.001) and cardiac death rate (17.7 versus 7.5%, HR 2.49, 95%CI 1.59~3.90, P < 0.001) at 1 year after admission compared patients with NSR. AF induced significantly higher all-cause mortality and cardiac mortality rate in STEMI patients who were appropriately revascularized with primary PCI compared to NSR at 1 year.
PMID
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Authors

Mayor MeshTerms
Keywords

Major adverse cardiac event

Normal sinus rhythm

Target lesion revascularization

Journal Title international heart journal
Publication Year Start




PMID- 28690292
OWN - NLM
STAT- Publisher
DA  - 20170710
LR  - 20170710
IS  - 1349-3299 (Electronic)
IS  - 1349-2365 (Linking)
DP  - 2017 Jul 10
TI  - Atrial Fibrillation on Admission Is Related With Higher Mortality in ST-Segment
      Elevation Myocardial Infarction Patients.
LID - 10.1536/ihj.16-286 [doi]
AB  - The prognostic significance of atrial fibrillation (AF) on mortality in
      ST-segment elevation myocardial infarction (STEMI) patients is not clearly
      understood. To elucidate the clinical significance of AF on mortality for 1 year 
      in STEMI patients, we retrospectively analyzed the Korea Acute Myocardial
      Infarction Registry (KAMIR) database, which spans January 2008 to September 2010 
      and includes 14,329 patients with acute myocardial infarction. We selected 5,556 
      patients with marked ECG rhythm (NSR, normal sinus rhythm or AF) on emergency
      room arrival, &lt; 12 hours of symptom onset, and who underwent primary percutaneous
      coronary intervention (PCI) within 90 minutes of arriving at the hospital.
      Patients who had been followed-up for at least for 1 year were analyzed (2,636 of
      NSR, 119 of AF). At enrollment, AF patients were older (70.7 versus 65.5 years, P
      &lt; 0.001) and had lower systolic blood pressure (120.6 versus 125.9 mmHg, P =
      0.050), a higher heart rate (80.4 versus 75.6/minute, P = 0.009), and a higher
      rate of Killip III, IV (25.0 versus 14.2%, P = 0.002). Patients with AF showed
      clearly higher all-cause mortality (22.7 versus 9.5%, HR 2.51, 95%CI 1.68~3.76, P
      &lt; 0.001) and cardiac death rate (17.7 versus 7.5%, HR 2.49, 95%CI 1.59~3.90, P &lt; 
      0.001) at 1 year after admission compared patients with NSR. AF induced
      significantly higher all-cause mortality and cardiac mortality rate in STEMI
      patients who were appropriately revascularized with primary PCI compared to NSR
      at 1 year.
FAU - Hwang, Kyung-Kuk
AU  - Hwang KK
AD  - Chungbuk Regional Cardiovascular Center, Division of Cardiology, Department of
      Internal Medicine, Chungbuk National University Hospital.
AD  - Department of Internal Medicine, College of Medicine, Chungbuk National
      University.
FAU - Eom, Sang-Yong
AU  - Eom SY
AD  - Department of Preventive Medicine, College of Medicine, Chungbuk National
      University.
FAU - Lee, Sang Yeub
AU  - Lee SY
AD  - Chungbuk Regional Cardiovascular Center, Division of Cardiology, Department of
      Internal Medicine, Chungbuk National University Hospital.
FAU - Kim, Sang Min
AU  - Kim SM
AD  - Chungbuk Regional Cardiovascular Center, Division of Cardiology, Department of
      Internal Medicine, Chungbuk National University Hospital.
FAU - Cho, Myeong-Chan
AU  - Cho MC
AD  - Chungbuk Regional Cardiovascular Center, Division of Cardiology, Department of
      Internal Medicine, Chungbuk National University Hospital.
AD  - Department of Internal Medicine, College of Medicine, Chungbuk National
      University.
FAU - Kim, Young Jo
AU  - Kim YJ
AD  - Division of Cardiology, Department of Internal Medicine, Yeungnam University
      Hospital.
FAU - Seung, Ki Bae
AU  - Seung KB
AD  - Division of Cardiology, Department of Internal Medicine, Catholic University, St.
      Mary Hospital.
FAU - Jeong, Myung Ho
AU  - Jeong MH
AD  - Division of Cardiology, Department of Internal Medicine, Chonnam National
      University Hospital.
FAU - Bae, Jang-Whan
AU  - Bae JW
AD  - Chungbuk Regional Cardiovascular Center, Division of Cardiology, Department of
      Internal Medicine, Chungbuk National University Hospital.
AD  - Department of Internal Medicine, College of Medicine, Chungbuk National
      University.
CN  - other Korea Acute Myocardial Infarction Registry Investigators
LA  - eng
PT  - Journal Article
DEP - 20170710
PL  - Japan
TA  - Int Heart J
JT  - International heart journal
JID - 101244240
OTO - NOTNLM
OT  - Major adverse cardiac event
OT  - Normal sinus rhythm
OT  - Target lesion revascularization
EDAT- 2017/07/12 06:00
MHDA- 2017/07/12 06:00
CRDT- 2017/07/11 06:00
AID - 10.1536/ihj.16-286 [doi]
PST - aheadofprint
SO  - Int Heart J. 2017 Jul 10. doi: 10.1536/ihj.16-286.