title: Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real-world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000-2013.
abstract: BACKGROUND
  The past decade has brought major advances in therapy of patients presenting with acute coronary syndromes (ACS).
  
  
  OBJECTIVE
  The outcomes of ACS patients with atrial fibrillation (AF) has improved over the years.
  
  
  METHODS
  We evaluated time-dependent changes in clinical characteristics, management strategies, and outcomes associated with AF observed during ACS hospitalization in patients enrolled in the biannual ACS Israeli Surveys (ACSIS) between 2000 and 2013. We divided the surveys into early (2000-2006) and late (2008-2013) time periods.
  
  
  RESULTS
  The study population comprised 13 297 ACS patients, of whom 755 (5.7%) either presented with or developed AF during the index hospitalization. The incidence of AF observed during ACS hospitalization was lower during the later period (6.2% vs 4.9%; P < 0.01). Kaplan-Meier survival analysis showed that 1-year mortality rates were significantly lower among ACS patients with and without AF who were enrolled during the later vs early survey period (log-rank P < 0.01 for the overall difference). However, AF observed among ACS patients was still associated with increased risk for in-hospital complications and 30-day and 1-year mortality during both the early and late survey periods (P < 0.05 for all comparisons).
  
  
  CONCLUSIONS
  In 10 years, rates of AF among ACS patients have declined significantly. Yet, despite improved overall 1-year survival for patients with AF, the development of AF in this population remains an independent predictor of mortality that has not changed appreciably over the years.
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Aharon
authors.initials: A
authors.lastname: Erez
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Sabbag
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Nof
authors.affiliation: Intensive Cardiac Care Unit, Department of Cardiology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
authors.affiliation: Cardiology Department, Galilee Medical Center, Nahariya, Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Atar
authors.affiliation: Heart Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Arthur
authors.initials: A
authors.lastname: Pollak
authors.affiliation: Department of Cardiology, Bnai Zion Medical Center, and the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute ofTechnology, Haifa, Israel.
authors.forename: Idit
authors.initials: I
authors.lastname: Dobrecky-Merye
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Beigel
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Glikson
authors.affiliation: Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Beinart
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D006306:Health Surveys; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: ACSIS registry; Acute coronary syndrome; atrial fibrillation