title: Prognostic significance of new atrial fibrillation and its relation to heart failure following acute myocardial infarction.
abstract: BACKGROUND
  New-onset atrial fibrillation (AF) after acute myocardial infarction (AMI) frequently occurs in association with postinfarction complications, particularly with heart failure (HF).
  
  
  OBJECTIVE
  To evaluate whether postinfarction HF is associated with the subsequent development of AF and whether AF independently predicts poorer prognosis.
  
  
  RESULTS
  We examined 650 patients with AMI and compared patients with AF (n=320) to those without (n=330). AF patients were classified as either early AF (n=208)-patients who developed AF within 24 h of symptom onset or late AF (n=112)-patients who had AF thereafter. We compared outcomes between these groups, adjusting for differences in baseline characteristics and postinfarction HF. Heart failure was the most important predictor of AF. In most patients, AF occurred secondary to HF. AF patients had poorer outcomes, including higher in-hospital and 7-year mortality. After multivariate adjustment, overall, AF was not an independent predictor of in-hospital [odds ratio (OR)=0.70) and 7-year [relative risk (RR)=1.14] mortality, but late AF remained an independent predictor of 7-year (RR=2.48, 95% confidence interval, 1.26-4.87) mortality.
  
  
  CONCLUSIONS
  Heart failure mostly preceded the occurrence of new-onset atrial fibrillation after acute myocardial infarction, but only late atrial fibrillation was independently related to long-term mortality.
authors.affiliation: University Institute for Cardiovascular Disease, Clinical Center of Serbia, Emergency Center, Pasterova 2, 11000 Belgrade, Serbia&Montenegro. masanin@Eunet.yu
authors.forename: Milika
authors.initials: M
authors.lastname: Asanin
authors.forename: Jovan
authors.initials: J
authors.lastname: Perunicic
authors.forename: Igor
authors.initials: I
authors.lastname: Mrdovic
authors.forename: Mihailo
authors.initials: M
authors.lastname: Matic
authors.forename: Bosiljka
authors.initials: B
authors.lastname: Vujisic-Tesic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Arandjelovic
authors.forename: Zorana
authors.initials: Z
authors.lastname: Vasiljevic
authors.forename: Miodrag
authors.initials: M
authors.lastname: Ostojic
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology; D011379:Prognosis; D016019:Survival Analysis