Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction

Background: Atrial fibrillation (AF) has been identified as a major risk factor for mortality after acute coronary syndrome (ACS). However, the long-term risk of ischemic stroke associated with new-onset atrial fibrillation (NOAF) in ACS remains controversial, and its gender-specific association is...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jeong-Eun Yi, Suk-Min Seo, Sungmin Lim, Eun-Ho Choo, Ik-Jun Choi, Kwan-Yong Lee, Byung-Hee Hwang, Chan-Joon Kim, Mahn-Won Park, Dong-Bin Kim, Sung-Ho Her, Jong-Min Lee, Chul-Soo Park, Pum-Joon Kim, Hee-Yeol Kim, Ki-Dong Yoo, Doo-Soo Jeon, Wook-Sung Chung, Myung-Ho Jeong, Youngkeun Ahn, Kiyuk Chang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	new onset atrial fibrillation acute myocardial infarction ischemic stroke gender differences Medicine R
Acceso en línea:	https://doaj.org/article/988ce599126f4a4f8580f8b2885fec82
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:988ce599126f4a4f8580f8b2885fec82
record_format	dspace
spelling	oai:doaj.org-article:988ce599126f4a4f8580f8b2885fec822021-11-11T17:45:51ZGender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction10.3390/jcm102151412077-0383https://doaj.org/article/988ce599126f4a4f8580f8b2885fec822021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5141https://doaj.org/toc/2077-0383Background: Atrial fibrillation (AF) has been identified as a major risk factor for mortality after acute coronary syndrome (ACS). However, the long-term risk of ischemic stroke associated with new-onset atrial fibrillation (NOAF) in ACS remains controversial, and its gender-specific association is unknown. Methods: We analyzed the data of 10,137 ACS survivors included in a multicenter, prospective registry for Korean patients with acute myocardial infarction (AMI) between January 2004 and August 2014. Subjects were categorized into three groups (non-AF vs. NOAF vs. previous AF) based on medical history and electrocardiographic evidence of AF, either at admission or during hospitalization. Results: Among the total study population (72.3% men), 370 patients (3.6%) had NOAF and 130 (1.3%) had previous AF. During a median follow-up of 61 months (interquartile range, 38.8 to 89.3 months), 245 (2.4%) patients (218 (2.3%) non-AF vs. 15 (4.1%) NOAF vs. 12 (9.2%) previous AF, <i>p</i> < 0.001) experienced ischemic stroke. After adjustment for confounding variables, both NOAF (adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.09–3.24, <i>p</i> = 0.024) and previous AF (adjusted HR 4.00, 95% CI 2.03–7.87, <i>p</i> < 0.001), along with older age, diabetes, current smoker, and previous stroke were independent risk factors of ischemic stroke. In the gender-stratified analysis, men with previous AF but not NOAF had a significantly higher risk of ischemic stroke (adjusted HR 4.14, 95% CI 1.79–9.55, <i>p</i> = 0.001) than those without AF. In women, NOAF (adjusted HR 2.54, 95% CI 1.21–5.35, <i>p</i> = 0.014) as well as previous AF (adjusted HR 3.72, 95% CI 1.16–11.96, <i>p</i> = 0.028) was a strong predictor of ischemic stroke, and the predictive value was comparable to that of previous AF among patients with a CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥ 2. Conclusions: Both NOAF and previous AF were associated with ischemic stroke after AMI, but the impact of NOAF as a risk factor of ischemic stroke was significant only in women.Jeong-Eun YiSuk-Min SeoSungmin LimEun-Ho ChooIk-Jun ChoiKwan-Yong LeeByung-Hee HwangChan-Joon KimMahn-Won ParkDong-Bin KimSung-Ho HerJong-Min LeeChul-Soo ParkPum-Joon KimHee-Yeol KimKi-Dong YooDoo-Soo JeonWook-Sung ChungMyung-Ho JeongYoungkeun AhnKiyuk ChangMDPI AGarticlenew onset atrial fibrillationacute myocardial infarctionischemic strokegender differencesMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5141, p 5141 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	new onset atrial fibrillation acute myocardial infarction ischemic stroke gender differences Medicine R
spellingShingle	new onset atrial fibrillation acute myocardial infarction ischemic stroke gender differences Medicine R Jeong-Eun Yi Suk-Min Seo Sungmin Lim Eun-Ho Choo Ik-Jun Choi Kwan-Yong Lee Byung-Hee Hwang Chan-Joon Kim Mahn-Won Park Dong-Bin Kim Sung-Ho Her Jong-Min Lee Chul-Soo Park Pum-Joon Kim Hee-Yeol Kim Ki-Dong Yoo Doo-Soo Jeon Wook-Sung Chung Myung-Ho Jeong Youngkeun Ahn Kiyuk Chang Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction
description	Background: Atrial fibrillation (AF) has been identified as a major risk factor for mortality after acute coronary syndrome (ACS). However, the long-term risk of ischemic stroke associated with new-onset atrial fibrillation (NOAF) in ACS remains controversial, and its gender-specific association is unknown. Methods: We analyzed the data of 10,137 ACS survivors included in a multicenter, prospective registry for Korean patients with acute myocardial infarction (AMI) between January 2004 and August 2014. Subjects were categorized into three groups (non-AF vs. NOAF vs. previous AF) based on medical history and electrocardiographic evidence of AF, either at admission or during hospitalization. Results: Among the total study population (72.3% men), 370 patients (3.6%) had NOAF and 130 (1.3%) had previous AF. During a median follow-up of 61 months (interquartile range, 38.8 to 89.3 months), 245 (2.4%) patients (218 (2.3%) non-AF vs. 15 (4.1%) NOAF vs. 12 (9.2%) previous AF, <i>p</i> < 0.001) experienced ischemic stroke. After adjustment for confounding variables, both NOAF (adjusted hazard ratio (HR) 1.87, 95% confidence interval (CI) 1.09–3.24, <i>p</i> = 0.024) and previous AF (adjusted HR 4.00, 95% CI 2.03–7.87, <i>p</i> < 0.001), along with older age, diabetes, current smoker, and previous stroke were independent risk factors of ischemic stroke. In the gender-stratified analysis, men with previous AF but not NOAF had a significantly higher risk of ischemic stroke (adjusted HR 4.14, 95% CI 1.79–9.55, <i>p</i> = 0.001) than those without AF. In women, NOAF (adjusted HR 2.54, 95% CI 1.21–5.35, <i>p</i> = 0.014) as well as previous AF (adjusted HR 3.72, 95% CI 1.16–11.96, <i>p</i> = 0.028) was a strong predictor of ischemic stroke, and the predictive value was comparable to that of previous AF among patients with a CHA<sub>2</sub>DS<sub>2</sub>-VASc score ≥ 2. Conclusions: Both NOAF and previous AF were associated with ischemic stroke after AMI, but the impact of NOAF as a risk factor of ischemic stroke was significant only in women.
format	article
author	Jeong-Eun Yi Suk-Min Seo Sungmin Lim Eun-Ho Choo Ik-Jun Choi Kwan-Yong Lee Byung-Hee Hwang Chan-Joon Kim Mahn-Won Park Dong-Bin Kim Sung-Ho Her Jong-Min Lee Chul-Soo Park Pum-Joon Kim Hee-Yeol Kim Ki-Dong Yoo Doo-Soo Jeon Wook-Sung Chung Myung-Ho Jeong Youngkeun Ahn Kiyuk Chang
author_facet	Jeong-Eun Yi Suk-Min Seo Sungmin Lim Eun-Ho Choo Ik-Jun Choi Kwan-Yong Lee Byung-Hee Hwang Chan-Joon Kim Mahn-Won Park Dong-Bin Kim Sung-Ho Her Jong-Min Lee Chul-Soo Park Pum-Joon Kim Hee-Yeol Kim Ki-Dong Yoo Doo-Soo Jeon Wook-Sung Chung Myung-Ho Jeong Youngkeun Ahn Kiyuk Chang
author_sort	Jeong-Eun Yi
title	Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction
title_short	Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction
title_full	Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction
title_fullStr	Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction
title_full_unstemmed	Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction
title_sort	gender differences in the impact of new-onset atrial fibrillation on long-term risk of ischemic stroke after acute myocardial infarction
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/988ce599126f4a4f8580f8b2885fec82
work_keys_str_mv	AT jeongeunyi genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT sukminseo genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT sungminlim genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT eunhochoo genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT ikjunchoi genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT kwanyonglee genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT byungheehwang genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT chanjoonkim genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT mahnwonpark genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT dongbinkim genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT sunghoher genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT jongminlee genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT chulsoopark genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT pumjoonkim genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT heeyeolkim genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT kidongyoo genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT doosoojeon genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT wooksungchung genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT myunghojeong genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT youngkeunahn genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction AT kiyukchang genderdifferencesintheimpactofnewonsetatrialfibrillationonlongtermriskofischemicstrokeafteracutemyocardialinfarction
_version_	1718432014239006720

Gender Differences in the Impact of New-Onset Atrial Fibrillation on Long-Term Risk of Ischemic Stroke after Acute Myocardial Infarction

Ejemplares similares