| Transient atrial fibrillation complicating acute inferior myocardial infarction: implications for future risk of ischemic stroke. | |
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MedLine Citation:
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PMID: 17400657 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Atrial fibrillation (AF) that occurs as a frequent complication of myocardial infarction (MI) is associated with a poor clinical outcome. It nonetheless remains uncertain whether AF that occurs transiently during MI is associated with a subsequent increased risk of the development of AF and ischemic stroke. METHODS: We retrospectively studied the impact of transient AF on the long-term risk of the occurrence of AF, ischemic stroke, and mortality in 431 consecutive patients (mean [+/- SEM] age, 64 +/- 1 years; 75% men). All patients had experienced an acute inferior ST-segment-elevation MI and had preserved left ventricular ejection fraction (LVEF) [> 45%]. RESULTS: All patients were in sinus rhythm on hospital admission, and transient AF was observed in 59 patients (13.7%) during their hospitalization for MI. On hospital discharge, all patients were in sinus rhythm and had been prescribed antiplatelet agents alone as antithrombotic therapy. Patients in whom transient AF developed during MI were older (mean age, 70 +/- 1.4 vs 64 +/- 0.7 years, respectively; p < 0.01) and more likely to be women (37% vs 23%, respectively; p < 0.02) compared with those without AF. At 1-year follow-up, the incidence of AF (22.0% vs 1.3%, respectively; p < 0.01) and ischemic stroke (10.2% vs 1.8%, respectively; p < 0.01) was higher in patients with transient AF than in those without transient AF. The total mortality rate was nonetheless similar (5.6% vs 6.8%, respectively; p = 0.73); Cox regression analysis demonstrated that age > 65 years and transient AF during MI were independent predictors of the subsequent occurrence of AF and the development of ischemic stroke. CONCLUSION: Transient AF complicating acute inferior MI is associated with an increased future risk of AF occurrence and ischemic stroke in patients with preserved LVEF, despite the use of antiplatelet therapy. |
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Authors:
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Chung-Wah Siu; Man-Hong Jim; Hee-Hwa Ho; Raymond Miu; Stephen W L Lee; Chu-Pak Lau; Hung-Fat Tse |
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Publication Detail:
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Type: Journal Article Date: 2007-03-30 |
Journal Detail:
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Title: Chest Volume: 132 ISSN: 0012-3692 ISO Abbreviation: Chest Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-12 Completed Date: 2007-08-14 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 44-9 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Division, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People's Republic of China. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticoagulants / therapeutic use Atrial Fibrillation / complications*, etiology*, physiopathology Female Humans Kaplan-Meiers Estimate Male Middle Aged Myocardial Infarction / complications*, drug therapy, physiopathology Regression Analysis Retrospective Studies Risk Factors Severity of Illness Index Stroke / etiology*, physiopathology, prevention & control Stroke Volume / physiology Treatment Outcome Ventricular Function, Left / physiology |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants |
| Comments/Corrections | |
Comment In:
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Chest. 2007 Jul;132(1):8-10
[PMID:
17625079
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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