Relation of Atrial Fibrillation in Acute Myocardial Infarction to In-Hospital Complications and Early Hospital Readmission
Department of Medicine; Department of Quantitative Health Sciences; Department of Emergency Medicine; Department of Medicine, Division of Cardiovascular Medicine
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology | Translational Medical Research
Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) and contributes to high rates of in-hospital adverse events. However, there are few contemporary studies examining rates of AF in the contemporary era of AMI or the impact of new-onset AF on key in-hospital and postdischarge outcomes. We examined trends in AF in 6,384 residents of Worcester, Massachusetts, who were hospitalized with confirmed AMI during 7 biennial periods between 1999 and 2011. Multivariate logistic regression analysis was used to examine associations between occurrence of AF and various in-hospital and postdischarge complications. The overall incidence of AF complicating AMI was 10.8%. Rates of new-onset AF increased from 1999 to 2003 (9.8% to 13.2%), and decreased thereafter. In multivariable adjusted models, patients developing new-onset AF after AMI were at a higher risk for in-hospital stroke (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.6 to 4.1), heart failure (OR 2.0, 95% CI 1.7 to 2.4), cardiogenic shock (OR 3.7, 95% CI 2.8 to 4.9), and death (OR 2.3, 95% CI 1.9 to 3.0) than patients without AF. Development of AF during hospitalization for AMI was associated with higher rates of readmission within 30 days after discharge (21.7% vs 16.0%), but no significant difference was noted in early postdischarge 30-day all-cause mortality rates (8.3% vs 5.1%). In conclusion, new-onset AF after AMI is strongly related to in-hospital complications of AMI and higher short-term readmission rates.
DOI of Published Version
Am J Cardiol. 2016 Apr 15;117(8):1213-8. doi: 10.1016/j.amjcard.2016.01.012. Epub 2016 Jan 28. Link to article on publisher's site
The American journal of cardiology
Kundu, Amartya; O'Day, Kevin; Shaikh, Amir Y.; Lessard, Darleen M.; Saczynski, Jane S.; Yarzebski, Jorge L.; Darling, Chad E.; Thabet, Ramses; Akhter, Mohammed W.; Floyd, Kevin C.; Goldberg, Robert J.; and McManus, David D., "Relation of Atrial Fibrillation in Acute Myocardial Infarction to In-Hospital Complications and Early Hospital Readmission" (2016). UMass Center for Clinical and Translational Science Supported Publications. 80.