Document Detail


Trends in atrial fibrillation in patients hospitalized with an acute coronary syndrome.
MedLine Citation:
PMID:  23098864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation is common among patients with cardiovascular disease and is a frequent complication of the acute coronary syndrome. Data are needed on recent trends in the magnitude, clinical features, treatment, and prognostic impact of preexisting and new-onset atrial fibrillation in patients hospitalized with an acute coronary syndrome.
METHODS: The study population consisted of 59,032 patients hospitalized with an acute coronary syndrome at 113 sites in the Global Registry of Acute Coronary Events Study between 2000 and 2007.
RESULTS: A total of 4494 participants (7.6%) with acute coronary syndrome reported a history of atrial fibrillation and 3112 participants (5.3%) developed new-onset atrial fibrillation during their hospitalization. Rates of new-onset atrial fibrillation (5.5%-4.5%) and preexisting atrial fibrillation (7.4%-6.7%) declined during the study. Preexisting atrial fibrillation was associated with older age and greater cardiovascular disease burden, whereas new-onset atrial fibrillation was closely related to the severity of the index acute coronary syndrome. Patients with atrial fibrillation were less likely than patients without atrial fibrillation to receive evidence-based therapies and more likely to develop in-hospital complications, including heart failure. Overall hospital death rates in patients with new-onset and preexisting atrial fibrillation were 14.5% and 8.9%, respectively, compared with 1.2% in those without atrial fibrillation. Short-term death rates in patients with atrial fibrillation declined over the study period.
CONCLUSIONS: Despite a reduction in the rates of, and mortality from, atrial fibrillation, this arrhythmia exerts a significant adverse effect on survival among patients hospitalized with an acute coronary syndrome. Opportunities exist to improve the identification and treatment of patients with acute coronary syndrome with, or at risk for, atrial fibrillation to reduce the incidence and resultant complications of this dysrhythmia.
Authors:
David D McManus; Wei Huang; Kunal V Domakonda; Jeanine Ward; Jane S Saczysnki; Joel M Gore; Robert J Goldberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of medicine     Volume:  125     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-26     Completed Date:  2013-03-28     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1076-84     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / complications*,  mortality
Aged
Atrial Fibrillation / epidemiology*,  etiology,  mortality
Comorbidity
Female
Hospital Mortality / trends*
Hospitalization / statistics & numerical data*
Humans
Incidence
Male
Middle Aged
Prognosis
Risk Factors
Survival Rate
Grant Support
ID/Acronym/Agency:
1U01HL105268-01/HL/NHLBI NIH HHS; K01 AG033643/AG/NIA NIH HHS; K01AG33643/AG/NIA NIH HHS; KL2 RR031981/RR/NCRR NIH HHS; KL2RR031981/RR/NCRR NIH HHS; U01 HL105268/HL/NHLBI NIH HHS
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