Atrial Fibrillation and Risk of ST-Segment–Elevation Versus Non–ST-Segment–Elevation Myocardial Infarction

• DOI: 10.1161/circulationaha.114.014145
• Publication Date: 2015-04-28T02:31:37Z
• Authors: Elsayed Z. Soliman; Faye Lopez; Wesley T. O’Neal; Lin Y. Chen; Lindsay Bengtson; Zhu-Ming Zhang; Laura Loehr; Mary Cushman; Alvaro Alonso
• Keywords: Male; Myocardial Infarction; Arrhythmias, Cardiac; Comorbidity; Middle Aged; Atherosclerosis; 3. Good health; Electrocardiography; 03 medical and health sciences; 0302 clinical medicine; Cardiac Conduction System Disease; Heart Conduction System; Risk Factors; Atrial Fibrillation; Hypertension; Diabetes Mellitus; Humans; Female; Kidney Diseases; Obesity; Brugada Syndrome; Dyslipidemias; Follow-Up Studies

Background— It has recently been reported that atrial fibrillation (AF) is associated with an increased risk of myocardial infarction (MI). However, the mechanism underlying this association currently unknown. Further study relationship AF type MI (ST-segment–elevation [STEMI] versus non–ST-segment–elevation [NSTEMI]) might shed light on potential mechanisms. Methods and Results— We examined between incident in 14 462 participants (mean age, 54 years; 56% women; 26% blacks) from Atherosclerosis Risk Communities (ARIC) who were free coronary heart disease at baseline (1987–1989) follow-up through December 31, 2010. cases identified visit ECGs by review hospital discharge records. Incident its types ascertained independent adjudication committee. Over a median 21.6 years, 1374 events occurred (829 NSTEMIs, 249 STEMIs, 296 unclassifiable MIs). In multivariable-adjusted model, (n=1545) as time-varying variable was 63% (hazard ratio,1.63; 95% confidence interval, 1.32–2.02). NSTEMI ratio, 1.80; 1.39–2.31) but not STEMI 0.49; 0.18–1.34; P for hazard ratio comparison=0.004). Combining group either or did change conclusion. The MI, total NSTEMI, stronger women than men ( interaction <0.01 both). Conclusions— especially women. limited to NSTEMI.