Impact of atrial fibrillation on the in-hospital and long-term survival of patients with acute myocardial infarction: a community-wide perspective
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Authors
Goldberg, Robert J.Seeley, D.
Becker, Richard C.
Brady, P.
Chen, Z. Y.
Osganian, Voula
Gore, Joel M.
Alpert, Joseph S.
Dalen, James E.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
1990-05-01Keywords
Age FactorsAtrial Fibrillation
Female
Hospitalization
Humans
Incidence
Male
Multivariate Analysis
Myocardial Infarction
Regression Analysis
Sex Factors
Survival Rate
Cardiology
Cardiovascular Diseases
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Show full item recordAbstract
As part of an ongoing community-wide study examining changes over time in the incidence and survival rates of 4108 patients hospitalized with validated acute myocardial infarction (MI) in 16 hospitals in the Worcester, Massachusetts, metropolitan area during calendar years 1975, 1978, 1981, 1984, and 1986, we examined changes over time in the proportion of patients with acute MI developing atrial fibrillation (AF) and the impact of AF on in-hospital and long-term survival for up to a 10-year follow-up period. The overall percentage of patients with AF complicating acute MI was 16.0%; this proportion increased over time from 13.3% in 1975 to 14.8% in 1978, 14.9% in 1981, 20.3% in 1984, and to 17.7% in 1986. Patients with AF experienced consistently higher in-hospital case fatality rates than MI patients without AF overall (27.6% versus 16.6%), as well as during each of the 5 years under study. The independent effect of AF on in-hospital survival was not upheld, however, when a variety of potentially confounding prognostic factors were controlled for in a multivariate analysis resulting in an adjusted odds ratio (OR) of 1.18 (95% confidence interval 0.90, 1.52). Among discharged hospital patients, while the crude long-term survival rate for patients with AF was poorer than that of patients without AF for the combined as well as for individual study periods, similar to the in-hospital findings the independent effect of AF on long-term prognosis was not upheld after use of a multivariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)Source
Am Heart J. 1990 May;119(5):996-1001.
DOI
10.1016/s0002-8703(05)80227-3Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47076PubMed ID
2330889Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/s0002-8703(05)80227-3