Author + information
- Adedotun Ogunsua1,
- Aditya Vaze1,
- Ibrahim Kassas1,
- Barinda Hansra1,
- Ahmed Nagy1,
- Rasha Elhag1,
- Jonathan Bisaillon1,
- Justice Oranefo1,
- Michael Gagnier1,
- Kevin O'Day1,
- Summer Aldrugh1,
- Antoine Soueid1,
- David McManus1,
- Mohammed Akhter1 and
- Deeqo Mohamud1
Atrial fibrillation (AF) is the most common sustained arrhythmia in developed countries. It is also frequently associated with acute myocardial infarction (AMI). AMI may occur in patients with AF through different mechanisms including prothrombotic state related to atherosclerosis, direct embolization from the left atrium into a coronary artery, and high ventricular rates resulting in demand supply mismatch. While there have been studies exploring the predictors of new onset AF after AMI, there is limited data in a contemporary population of patients following non ST elevation myocardial infarction acute coronary syndrome (NSTE-ACS).
743 patients discharged from the University of Massachusetts Medical Center after percutaneous coronary intervention (PCI) for NSTE-ACS between 2011 and 2014 were included in the analysis. Development of AF within a 30 day period was determined by comprehensive medical record review. Univariate models were constructed to identify risk factors associated with new onset AF. Factors associated with higher odds for new-onset AF were then included in multivariable regression models.
Incidence of new onset AF within 30 days after PCI for NSTE-ACS was 1.89%. Individuals with new onset AF were more likely to be younger, have a history of hypertension and higher cholesterol levels than individuals free from AF (Table). Analyses showed an association of new onset AF within 30-days after NSTE-ACS intervention in patients with underlying heart failure (p<0.05) and with increasing age (OR1.08 SD 1.036-1.12, p<0.001).
|Variable||AF||No AF||P value|
|Age mean, (SD)||69.1 (12.2)||72.7 (10.5)||<0.05|
|Smoker n, (%)||7 (13.4)||286 (30.3)||<0.05|
|Hypertension n, (%)||49 (94.2)||697 (73.9)||<0.05|
|Total Cholesterol mean,(SD)||172.8 (42.8)||153.4 (10.5)||0.01|
|Congestive Heart Failure, n (%)||13 (0.25)||81(6.5)||<0.05|
In this preliminary analysis of a contemporary cohort of patients presenting with NSTE-ACS, advancing age is associated with higher odds for developing new onset AF within 30-days after PCI. Since development of AF is associated with higher risk for stroke, rehospitalization and mortality, our findings have implications for monitoring and treatment of older patients with NSTE-ACS.