| Effect of atrial fibrillation on outcome in patients with known or suspected coronary artery disease referred for exercise stress testing. | |
| | |
MedLine Citation:
|
PMID: 20403467 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The association of atrial fibrillation (AF) with coronary artery disease (CAD) remains controversial. In addition, the relation of AF to myocardial ischemia and outcomes in patients with known or suspected CAD referred for exercise stress testing has been poorly explored. In this study, 17,100 patients aged > or = 50 years with known or suspected CAD who underwent exercise electrocardiography (n = 11,911) or exercise echocardiography (n = 5,189) were evaluated. End points were all-cause mortality, nonfatal myocardial infarction, and coronary revascularization. Overall, 619 patients presented with AF at the time of the tests. Patients with AF who had interpretable electrocardiograms had a lower likelihood of exercise-induced ischemic ST-segment abnormalities (adjusted odds ratio 0.51, 95% confidence interval 0.34 to 0.76, p = 0.001), and those with AF who underwent exercise echocardiography had a lower likelihood of new or worsening exercise-induced wall motion abnormalities (adjusted odds ratio 0.62, 95% confidence interval 0.44 to 0.87, p = 0.006). During a mean follow-up period of 6.5 + or - 3.9 years, 2,364 patients died, 1,311 had nonfatal myocardial infarctions, 1,615 underwent percutaneous coronary intervention, and 922 underwent coronary artery bypass surgery. The 10-year mortality rate was 43% in patients with AF compared to 19% in those without AF (p <0.001). In multivariate analysis, AF remained an independent predictor of all-cause mortality (adjusted hazard ratio 1.45, 95% confidence interval 1.20 to 1.76, p <0.001), but not of nonfatal myocardial infarction or coronary revascularization. In conclusion, despite being associated with an apparently lower likelihood of myocardial ischemia, AF was an independent predictor of all-cause mortality in patients with known or suspected CAD referred for exercise stress testing. |
| | |
Authors:
|
Alberto Bouzas-Mosquera; Jes?s Peteiro; Francisco J Broull?n; Nemesio Alvarez-Garc?a; Victor X Mosquera; Sheyla Casas; Alberto P?rez; Elizabet M?ndez; Alfonso Castro-Beiras |
Related Documents
:
|
9666527 - Whole-body exercise thallium imaging in smokers. 20122547 - Detection of coronary artery disease using delayed strain imaging at 5 min after the te... 3783927 - Analysis of the exercise-induced orthogonal p wave changes in normal subjects and patie... 11474157 - The peripheral vascular response to exercise is impaired in patients with risk factors ... 21983797 - Time course responses of serum gh, insulin, igf-1, igfbp1, and igfbp3 concentrations af... 3110887 - Alveolar-capillary diffusion of oxygen in dogs exercising in hypoxia. |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2010-03-11 |
Journal Detail:
|
Title: The American journal of cardiology Volume: 105 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-04-20 Completed Date: 2010-06-15 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1207-11 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Cardiology, Hospital Universitario A Coru?a, A Coru?a, Spain. aboumos@canalejo.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Atrial Fibrillation
/
complications*,
mortality,
physiopathology Cause of Death / trends Confidence Intervals Coronary Angiography Coronary Artery Disease / complications, diagnosis*, surgery Diagnosis, Differential Electrocardiography / methods* Exercise Test / methods* Female Follow-Up Studies Humans Male Middle Aged Myocardial Revascularization* Retrospective Studies Spain / epidemiology Survival Rate / trends Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Proteomic Profiling of Cellular Responses to Carvedilol Enantiomers in Vascular Smooth Muscle Cells ...
Next Document: Changes of myocardial function in patients with non-ST-elevation acute coronary syndrome awaiting co...