Atrial fibrillation during hospitalization for acute st-segment elevation myocardial infarction: prevalence, predictors, therapeutic impact and mortality

• DOI: 10.1093/ehjacc/zuad036.062
• Publication Date: 2023-05-03T00:35:01Z
• Authors: M Carias; M Paralta; A Almeida; F Claudio; R Rocha; B Picarra; A Bento; M Trinca
• Keywords: Stroke; valvular heart disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The presence Atrial Fibrillation (AF) in Acute Myocardial Infarction (AMI) is an important challenge antiplatelet and anticoagulant therapy may have impact on the prognosis these patients. Purpose To determine incidence AF during hospitalization for ST-elevated AMI (STEMI), identify possible predictors its onset assess mortality. Methods We studied 3254 patients with diagnosis STEMI included a multicenter national registry. considered 2 groups: without AF. Age, gender, cardiovascular non-cardiovascular history, number vessels lesions, angioplasties performed, performed at admission discharge were recorded. Left ventricular function (LVF), heart failure (HF), need invasive mechanical ventilation, complications, stroke, major hemorrhage, high-grade atrioventricular block (AVB) evaluated. In-hospital mortality was compared. Multivariate analysis to in-hospital Results found 6.1% (197 patients). older (71±12 vs 62±14 years; p<0.001), higher prevalence females (34.5% 24.4%, p=0.002), hypertension (72.4% 59.6%, valvular disease (3.7% 1.1%, p=0.008), HF (5.6% 1.8%, stroke (9.6% 5.6%, p=0.021) chronic renal (6.2% 2.8%, p=0.007). At time coronary angiography, there no differences type lesions. Patients received more vitamin K antagonists (7.7% 1.5% 12.3% 2.5%, diuretics (59.4% vs. 24.3% 51.3% 19.3%, aldosterone (27.0% 12.0% 25.0% 11.1% amiodarone (67.9% 4.1% 37.4% 1.6%, p<0.001) digoxin (10.2% 0.3% 2.6% 0.3%, p<0 .05). associated worse LVF (p<0.001), (46.2% 16.2%, ventilation (10.7% 3.4 %, complications (3.65 1.2%, p=0.013), (4.65 0.8%, AVB (12.7% 5.4 bleeding (6.1% p<0.001). (13.7% 4.6%, By multivariate analysis, per se not independent predictor following identified as AF: age history HF. Conclusion In our population STEMI, increase Age