Significance of recurrences of new atrial fibrillation in acute myocardial infarction.
BACKGROUND
Although new-onset atrial fibrillation (AF) frequently recurs following the acute myocardial infarction, the significance of AF recurrences is unknown.


OBJECTIVE
The objective of the present study was to evaluate the incidence, clinical predictors and prognostic significance of AF recurrences following the acute myocardial infarction.


RESULTS
A total of 320 consecutive patients with AF following the acute myocardial infarction were evaluated and the patients with AF recurrences were compared to those with single episodes of AF in whom AF did not recur after restoration of sinus rhythm. The incidence of AF recurrences was 22.5%. AF recurrences were highly associated with congestive heart failure and worse Killip class was identified as the most important predictor of AF recurrences. Patients with AF recurrences had poorer outcome, including higher in-hospital (36.1% versus 12.9%) and 7-year (68.2% versus 48.6%) mortality. After multivariate adjustment, AF recurrence remained an independent predictor of in-hospital [odds ratio (OR) = 3.08, 95% confidence interval (CI), 1.45-6.53, p = 0.001], and 7-year [relative risk (RR) = 1.52, 95% CI, 1.00-2.31, p = 0.026] mortality.


CONCLUSIONS
New-onset AF frequently recurs following the acute myocardial infarction and our analysis demonstrated that recurrences of AF independently predicted in-hospital and long-term mortality.
Asanin
Milika
M
University Institute for Cardiovascular Disease, Clinical Center of Serbia, Emergency Center, Belgrade, Serbia&Montenegro. masanin@Eunet.yu
Perunicic
Jovan
J
Mrdovic
Igor
I
Matic
Mihailo
M
Vujisic-Tesic
Bosiljka
B
Arandjelovic
Aleksandra
A
Vojvodic
Ana
A
Marinkovic
Jelena
J
Ostojic
Miodrag
M
Vasiljevic
Zorana
Z
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors