Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction

Background It remains controversial whether long‐term clinical impact of newly diagnosed atrial fibrillation (AF) in the acute phase of acute myocardial infarction (AMI) is different from that of prior AF diagnosed before the onset of AMI. Methods and Results The current study population from the CR...

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Autores principales:	Yuki Obayashi, Hiroki Shiomi, Takeshi Morimoto, Yodo Tamaki, Moriaki Inoko, Ko Yamamoto, Yasuaki Takeji, Tomohisa Tada, Kazuya Nagao, Kyohei Yamaji, Kazuhisa Kaneda, Satoru Suwa, Toshihiro Tamura, Hiroki Sakamoto, Tsukasa Inada, Mitsuo Matsuda, Yukihito Sato, Yutaka Furukawa, Kenji Ando, Kazushige Kadota, Yoshihisa Nakagawa, Takeshi Kimura
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	acute myocardial infarction anticoagulation atrial fibrillation percutaneous coronary intervention stroke Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/ea6ab71aff374f0fafb228a49bf689e3
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spelling	oai:doaj.org-article:ea6ab71aff374f0fafb228a49bf689e32021-11-23T11:36:35ZNewly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction10.1161/JAHA.121.0214172047-9980https://doaj.org/article/ea6ab71aff374f0fafb228a49bf689e32021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021417https://doaj.org/toc/2047-9980Background It remains controversial whether long‐term clinical impact of newly diagnosed atrial fibrillation (AF) in the acute phase of acute myocardial infarction (AMI) is different from that of prior AF diagnosed before the onset of AMI. Methods and Results The current study population from the CREDO‐Kyoto AMI (Coronary Revascularization Demonstrating Outcome Study in Kyoto Acute Myocardial Infarction) Registry Wave‐2 consisted of 6228 patients with AMI who underwent percutaneous coronary intervention. The baseline characteristics and long‐term clinical outcomes were compared according to AF status (newly diagnosed AF: N=489 [7.9%], prior AF: N=589 [9.5%], and no AF: N=5150 [82.7%]). Median follow‐up duration was 5.5 years. Patients with newly diagnosed AF and prior AF had similar baseline characteristics with higher risk profile than those with no AF including older age and more comorbidities. The cumulative 5‐year incidence of all‐cause death was higher in newly diagnosed AF and prior AF than no AF (38.8%, 40.7%, and 18.7%, P<0.001). The adjusted hazard ratios (HRs) for mortality of newly diagnosed AF and prior AF relative to no AF remained significant with similar magnitude (HR, 1.31; 95% CI, 1.12–1.54; P<0.001, and HR, 1.32; 95% CI, 1.14–1.52; P<0.001, respectively). The cumulative 5‐year incidence of stroke decreased in the order of newly diagnosed AF, prior AF and no AF (15.5%, 12.9%, and 6.3%, respectively, P<0.001). The higher adjusted HRs of both newly diagnosed AF and prior AF relative to no AF were significant for stroke, with a greater risk of newly diagnosed AF than that of prior AF (HR, 2.05; 95% CI, 1.56–2.69; P<0.001, and HR, 1.33; 95% CI, 1.00–1.78; P=0.048, respectively). The higher stroke risk of newly diagnosed AF compared with prior AF was largely driven by the greater risk within 30 days. The higher adjusted HRs of newly diagnosed AF and prior AF relative to no AF were significant for heart failure hospitalization (HR, 1.73; 95% CI, 1.35–2.22; P<0.001, and HR, 2.23; 95% CI, 1.82–2.74; P<0.001, respectively) and major bleeding (HR, 1.46; 95% CI, 1.23–1.73; P<0.001, and HR, 1.36; 95% CI, 1.15–1.60; P<0.001, respectively). Conclusions Newly diagnosed AF in AMI had risks for mortality, heart failure hospitalization, and major bleeding higher than no AF, and comparable to prior AF. The risk of newly diagnosed AF for stroke might be higher than that of prior AF.Yuki ObayashiHiroki ShiomiTakeshi MorimotoYodo TamakiMoriaki InokoKo YamamotoYasuaki TakejiTomohisa TadaKazuya NagaoKyohei YamajiKazuhisa KanedaSatoru SuwaToshihiro TamuraHiroki SakamotoTsukasa InadaMitsuo MatsudaYukihito SatoYutaka FurukawaKenji AndoKazushige KadotaYoshihisa NakagawaTakeshi KimuraWileyarticleacute myocardial infarctionanticoagulationatrial fibrillationpercutaneous coronary interventionstrokeDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute myocardial infarction anticoagulation atrial fibrillation percutaneous coronary intervention stroke Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	acute myocardial infarction anticoagulation atrial fibrillation percutaneous coronary intervention stroke Diseases of the circulatory (Cardiovascular) system RC666-701 Yuki Obayashi Hiroki Shiomi Takeshi Morimoto Yodo Tamaki Moriaki Inoko Ko Yamamoto Yasuaki Takeji Tomohisa Tada Kazuya Nagao Kyohei Yamaji Kazuhisa Kaneda Satoru Suwa Toshihiro Tamura Hiroki Sakamoto Tsukasa Inada Mitsuo Matsuda Yukihito Sato Yutaka Furukawa Kenji Ando Kazushige Kadota Yoshihisa Nakagawa Takeshi Kimura Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
description	Background It remains controversial whether long‐term clinical impact of newly diagnosed atrial fibrillation (AF) in the acute phase of acute myocardial infarction (AMI) is different from that of prior AF diagnosed before the onset of AMI. Methods and Results The current study population from the CREDO‐Kyoto AMI (Coronary Revascularization Demonstrating Outcome Study in Kyoto Acute Myocardial Infarction) Registry Wave‐2 consisted of 6228 patients with AMI who underwent percutaneous coronary intervention. The baseline characteristics and long‐term clinical outcomes were compared according to AF status (newly diagnosed AF: N=489 [7.9%], prior AF: N=589 [9.5%], and no AF: N=5150 [82.7%]). Median follow‐up duration was 5.5 years. Patients with newly diagnosed AF and prior AF had similar baseline characteristics with higher risk profile than those with no AF including older age and more comorbidities. The cumulative 5‐year incidence of all‐cause death was higher in newly diagnosed AF and prior AF than no AF (38.8%, 40.7%, and 18.7%, P<0.001). The adjusted hazard ratios (HRs) for mortality of newly diagnosed AF and prior AF relative to no AF remained significant with similar magnitude (HR, 1.31; 95% CI, 1.12–1.54; P<0.001, and HR, 1.32; 95% CI, 1.14–1.52; P<0.001, respectively). The cumulative 5‐year incidence of stroke decreased in the order of newly diagnosed AF, prior AF and no AF (15.5%, 12.9%, and 6.3%, respectively, P<0.001). The higher adjusted HRs of both newly diagnosed AF and prior AF relative to no AF were significant for stroke, with a greater risk of newly diagnosed AF than that of prior AF (HR, 2.05; 95% CI, 1.56–2.69; P<0.001, and HR, 1.33; 95% CI, 1.00–1.78; P=0.048, respectively). The higher stroke risk of newly diagnosed AF compared with prior AF was largely driven by the greater risk within 30 days. The higher adjusted HRs of newly diagnosed AF and prior AF relative to no AF were significant for heart failure hospitalization (HR, 1.73; 95% CI, 1.35–2.22; P<0.001, and HR, 2.23; 95% CI, 1.82–2.74; P<0.001, respectively) and major bleeding (HR, 1.46; 95% CI, 1.23–1.73; P<0.001, and HR, 1.36; 95% CI, 1.15–1.60; P<0.001, respectively). Conclusions Newly diagnosed AF in AMI had risks for mortality, heart failure hospitalization, and major bleeding higher than no AF, and comparable to prior AF. The risk of newly diagnosed AF for stroke might be higher than that of prior AF.
format	article
author	Yuki Obayashi Hiroki Shiomi Takeshi Morimoto Yodo Tamaki Moriaki Inoko Ko Yamamoto Yasuaki Takeji Tomohisa Tada Kazuya Nagao Kyohei Yamaji Kazuhisa Kaneda Satoru Suwa Toshihiro Tamura Hiroki Sakamoto Tsukasa Inada Mitsuo Matsuda Yukihito Sato Yutaka Furukawa Kenji Ando Kazushige Kadota Yoshihisa Nakagawa Takeshi Kimura
author_facet	Yuki Obayashi Hiroki Shiomi Takeshi Morimoto Yodo Tamaki Moriaki Inoko Ko Yamamoto Yasuaki Takeji Tomohisa Tada Kazuya Nagao Kyohei Yamaji Kazuhisa Kaneda Satoru Suwa Toshihiro Tamura Hiroki Sakamoto Tsukasa Inada Mitsuo Matsuda Yukihito Sato Yutaka Furukawa Kenji Ando Kazushige Kadota Yoshihisa Nakagawa Takeshi Kimura
author_sort	Yuki Obayashi
title	Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
title_short	Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
title_full	Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
title_fullStr	Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
title_full_unstemmed	Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction
title_sort	newly diagnosed atrial fibrillation in acute myocardial infarction
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/ea6ab71aff374f0fafb228a49bf689e3
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Newly Diagnosed Atrial Fibrillation in Acute Myocardial Infarction

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