title: Prognostic significance of atrial fibrillation/atrial flutter in patients with acute myocardial infarction treated with percutaneous coronary intervention.
abstract: Atrial fibrillation (AF) is a frequent complication after acute myocardial infarction (AMI) that has been associated with increased in-hospital and long-term mortality rates in the prethrombolytic and thrombolytic eras. Current therapies, including percutaneous coronary intervention (PCI), are effective in reducing mortality in patients with AMI. However, little is known concerning the incidence and prognostic significance of AF in patients with AMI who are treated with PCI. We evaluated 2,475 consecutive patients with AMI who underwent PCI within 24 hours after onset and who were enrolled in the Osaka Acute Coronary Insufficiency Study. Patients were categorized into 2 groups according to the presence of AF or atrial flutter. The incidence of AF was 12.0%. Patients with AF were older, were in higher Killip classes, had higher rates of previous myocardial infarction and previous cerebrovascular disease, had systolic blood pressure of <100 mm Hg and heart rates of > or =100 beats/min, multivessel disease, and had poorer reperfusion of the infarct-related artery than those without AF. Patients with AF had higher in-hospital (16.0% vs 6.7%, p <0.001) and 1-year (18.9% vs 7.9%, p <0.001) mortality than those without AF. Multivariate Cox regression analysis revealed that AF was an independent predictor of 1-year mortality (hazard ratio 1.64, 95% confidence interval 1.05 to 2.55) but was not a predictor of in-hospital mortality. AF is a common complication in patients with AMI who are treated with PCI and independently influences 1-year mortality.
authors: Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Kunihiro
authors: K
authors: Kinjo
authors: Hiroshi
authors: H
authors: Sato
authors: Hideyuki
authors: H
authors: Sato
authors: Yozo
authors: Y
authors: Ohnishi
authors: Eiji
authors: E
authors: Hishida
authors: Daisaku
authors: D
authors: Nakatani
authors: Hiroya
authors: H
authors: Mizuno
authors: Masatake
authors: M
authors: Fukunami
authors: Yukihiro
authors: Y
authors: Koretsune
authors: Hiroshi
authors: H
authors: Takeda
authors: Masatsugu
authors: M
authors: Hori
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology; D001282:Atrial Flutter / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome