Document Detail


Transient atrial fibrillation complicating acute inferior myocardial infarction: implications for future risk of ischemic stroke.
MedLine Citation:
PMID:  17400657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article     Date:  2007-03-30
Journal Detail:
Title:  Chest     Volume:  132     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-12     Completed Date:  2007-08-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  44-9     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Division, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anticoagulants
Comments/Corrections
Comment In:
Chest. 2007 Jul;132(1):8-10   [PMID:  17625079 ]

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