title: Short- and long-term prognosis of previous and new-onset atrial fibrillation in ST-segment elevation acute myocardial infarction.
abstract: OBJECTIVE
  The impact of atrial fibrillation on the prognosis of myocardial infarction is still the subject of debate. We analyzed the influence of previous and new-onset atrial fibrillation on in-hospital and long-term prognosis in patients with acute myocardial infarction.
  
  
  METHODS
  Prospective study of 4284 patients with ST-segment elevation acute myocardial infarction. We studied all-cause in-hospital and long-term mortality (median, 7.2 years) using adjusted models.
  
  
  RESULTS
  In total, 3.2% of patients had previous atrial fibrillation and 9.8% had new-onset atrial fibrillation. In general, both groups of patients had a high baseline risk profile and an increased likelihood of in-hospital complications. The crude in-hospital mortality rate was higher in patients with previous atrial fibrillation than in those with new-onset atrial fibrillation (22% vs 12%; P<.001; 30% vs 10%; P<.001). The long-term mortality rate was 11.11/100 patient-years in patients with previous atrial fibrillation and 5.35/100 patient years in those with new-onset atrial fibrillation (both groups, P<.001). New-onset fibrillation alone (odds ratio=1.55; 95% confidence interval, 1.08-2.22) was an independent predictor of in-hospital mortality. Previous atrial fibrillation (hazard ratio=1.24; 95% confidence interval, 0.94-1.64) and new-onset atrial fibrillation (hazard ratio=0.98; 95% confidence interval, 0.80-1.21) were not independent predictors of long-term mortality.
  
  
  CONCLUSIONS
  New-onset atrial fibrillation during hospitalization is an independent risk factor for in-hospital mortality in acute myocardial infarction.
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain. Electronic address: lconsue@gmail.com.
authors.forename: Luciano
authors.initials: L
authors.lastname: Consuegra-Sánchez
authors.affiliation: Servicio de Medicina Intensiva, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Melgarejo-Moreno
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Galcerá-Tomás
authors.affiliation: Servicio de Medicina Intensiva, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Alonso-Fernández
authors.affiliation: Servicio de Medicina Intensiva, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Díaz-Pastor
authors.affiliation: Servicio de Medicina Intensiva, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: Germán
authors.initials: G
authors.lastname: Escudero-García
authors.affiliation: Servicio de Cardiología, Hospital General Universitario de Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Jaulent-Huertas
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Vicente-Gilabert
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: Atrial fibrillation; Fibrilación auricular; Infarto de miocardio; Myocardial infarction; Prognosis; Pronóstico