title: Atrial fibrillation and mortality in patients with acute myocardial infarction: a systematic overview and meta-analysis.
abstract: Atrial fibrillation (AF) confers an increased risk of mortality in patients hospitalized for acute myocardial infarction (AMI). However, it is unclear whether new-onset and preexisting AF portend a different risk. We extracted data from studies that evaluated in-hospital mortality in patients with AMI and included information on cardiac rhythm. Overall, the risk of mortality was higher in patients with AF than in those in sinus rhythm (OR 2.00, 95 % CI: 1.93-2.08; P < 0.0001). Compared with patients who remained in sinus rhythm, the risk of death was increased in patients with new AF certain (sinus rhythm on admission, new AF during hospitalization, and history of no evidence of prior AF; OR 3.38, 95 % CI: 2.98-3.83; P < 0.0001), new AF uncertain (sinus rhythm on admission, AF during hospitalization, but no clear information about previous history of AF; OR 1.90, 95 % CI:1.83-1.98; P < 0.0001), and permanent AF (AF before and during hospitalization; OR 2.01, 95 % CI:1.70-2.38;P < 0.0001). In a meta-regression analysis, the risk of death was 87 % higher in patients with new AF certain than in those with permanent AF (P = 0.013) or AF uncertain (P = 0.003), and not dissimilar in patients with new AF uncertain and permanent AF (P = 0.706).
authors: Section of Cardiology, Hospital Media Valle del Tevere, AUSL 2, Umbria, Italy. fangeli@cardionet.it
authors: Fabio
authors: F
authors: Angeli
authors: Gianpaolo
authors: G
authors: Reboldi
authors: Marta
authors: M
authors: Garofoli
authors: Elisa
authors: E
authors: Ramundo
authors: Cristina
authors: C
authors: Poltronieri
authors: Giovanni
authors: G
authors: Mazzotta
authors: Giuseppe
authors: G
authors: Ambrosio
authors: Paolo
authors: P
authors: Verdecchia
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000401:mortality; D001281:Atrial Fibrillation / Q000150:complications / Q000209:etiology / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors