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 A, O'Day K, Shaikh AY, Lessard DM, Saczynski JS, Yarzebski JL, Darling CE, Thabet R, Akhter MW, Floyd KC, Goldberg RJ, McManus DD. (2016). Relation of Atrial Fibrillation in Acute Myocardial Infarction to In-Hospital Complications and Early Hospital Readmission. UMass Center for Clinical and Translational Science Supported Publications. https://doi.org/10.1016/j.amjcard.2016.01.012. Retrieved from https://escholarship.umassmed.edu/umccts_pubs/80