title: Prognosis of patients with atrial fibrillation undergoing percutaneous coronary intervention receiving drug eluting stents.
abstract: BACKGROUND
  Atrial fibrillation (AF) is increasingly prevalent in elderly patients and adversely affects clinical outcomes after coronary artery bypass grafting, non-cardiac surgery or myocardial infarction. Aim of the present analysis was to investigate the prognostic impact of AF in patients undergoing drug eluting stent (DES) implantation during a 1-year follow-up.
  
  
  METHODS
  5,772 consecutive patients undergoing percutaneous coronary intervention were enrolled into the German Drug Eluting Stent Registry (DES.DE) and were followed for 12 months. Of these 455 had AF and 5,317 in sinus rhythm served as controls. Univariate and multivariate logistic regression analyses were used to determine the risk of major adverse cardiac and cerebrovascular events (MACCE) and bleeding complications.
  
  
  RESULTS
  Patients with AF were older (71.3 ± 7.6 vs. 64.7 ± 10.5 years) and had a higher prevalence of diabetes, hypertension, renal insufficiency as well as more prior bypass surgery, stroke and peripheral arterial disease. Cardiogenic shock (2.9 vs. 1.4 %; p < 0.05), left ventricular ejection fraction ≤40 % (21.0 vs. 11.4 %; p < 0.0001) and triple vessel disease (44.4 vs. 37.9 %; p < 0.01) were more frequent in patients with AF than in controls. MACCE (OR 2.08, 95 % CI 1.56-2.77), total mortality (OR 3.27, 95 % CI 2.32-4.62) and non-fatal stroke (OR 2.03, 95 % CI 1.03-4.00) as well as bleeding complications (OR 1.88, 95 % CI 1.13-3.12) during the 1-year follow-up were more frequent in patients with AF (univariate analysis). In multivariate analyses adjusting for covariates determined to be relevant at baseline, the risk for total mortality remained elevated (OR 1.63, 95 % CI 1.05-2.52).
  
  
  CONCLUSIONS
  AF is an important predictor of long-term mortality in patients undergoing DES implantation.
authors.affiliation: Institut für Pharmakologie und präventive Medizin, Mahlow, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Bramlage
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cuneo
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Sigmund
authors.initials: S
authors.lastname: Silber
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
authors.forename: Ulrich
authors.initials: U
authors.lastname: Tebbe
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000601:surgery*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D005858:Germany; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D012042:Registries; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors