title: The risk for acute coronary syndrome associated with atrial fibrillation among ED patients with chest pain syndromes.
abstract: OBJECTIVE
  We sought to determine if atrial fibrillation is associated with an increased risk for an acute coronary syndrome (ACS) among emergency department (ED) patients with chest pain syndromes.
  
  
  METHODS
  We performed a retrospective analysis of a prospectively collected database on ED patients with chest pain by selecting patients with atrial fibrillation and frequency-matched control subjects without atrial fibrillation. Measured outcomes were acute myocardial infarction (AMI), ACS, and unstable angina (UA). The relative risks of AMI, ACS, and UA associated with atrial fibrillation were calculated.
  
  
  RESULTS
  One hundred forty patients with atrial fibrillation and 683 matched control subjects were identified. The rates of AMI for the atrial fibrillation and control groups were 11.4% and 10.8%, respectively; those of ACS were 27.9% and 26.7%, respectively; and those of UA were 16.4% and 15.8%, respectively. The relative risks of AMI and ACS did not increase in patients with atrial fibrillation: AMI, 1.05 (95% confidence interval [CI] = 0.63-1.75); ACS, 1.05 (95% CI = 0.78-1.40); and UA, 1.05 (95% CI = 0.6-1.7).
  
  
  CONCLUSIONS
  Among patients presenting to the ED with chest pain syndromes, atrial fibrillation is not associated with an increased risk for AMI, ACS, and UA.
authors.affiliation: Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Brown
authors.forename: Keara L
authors.initials: KL
authors.lastname: Sease
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Robey
authors.forename: Frances S
authors.initials: FS
authors.lastname: Shofer
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000209:etiology* / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D016022:Case-Control Studies; D002637:Chest Pain / Q000209:etiology / Q000503:physiopathology; D016001:Confidence Intervals; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors