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Article: Transient atrial fibrillation complicating acute inferior myocardial infarction: Implications for future risk of ischemic stroke

TitleTransient atrial fibrillation complicating acute inferior myocardial infarction: Implications for future risk of ischemic stroke
Authors
Issue Date2007
PublisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org
Citation
Chest, 2007, v. 132 n. 1, p. 44-49 How to Cite?
AbstractBackground: 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.
Persistent Identifierhttp://hdl.handle.net/10722/76311
ISSN
2015 Impact Factor: 5.94
2015 SCImago Journal Rankings: 3.176
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSiu, CWen_HK
dc.contributor.authorJim, MHen_HK
dc.contributor.authorHo, HHen_HK
dc.contributor.authorMiu, Ren_HK
dc.contributor.authorLee, SWLen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorTse, HFen_HK
dc.date.accessioned2010-09-06T07:19:53Z-
dc.date.available2010-09-06T07:19:53Z-
dc.date.issued2007en_HK
dc.identifier.citationChest, 2007, v. 132 n. 1, p. 44-49en_HK
dc.identifier.issn0012-3692en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76311-
dc.description.abstractBackground: 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.en_HK
dc.languageengen_HK
dc.publisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.orgen_HK
dc.relation.ispartofChesten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAnticoagulants - therapeutic useen_HK
dc.subject.meshAtrial Fibrillation - complications - etiology - physiopathologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKaplan-Meier Estimateen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMyocardial Infarction - complications - drug therapy - physiopathologyen_HK
dc.subject.meshRegression Analysisen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshStroke - etiology - physiopathology - prevention & controlen_HK
dc.subject.meshStroke Volume - physiologyen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshVentricular Function, Left - physiologyen_HK
dc.titleTransient atrial fibrillation complicating acute inferior myocardial infarction: Implications for future risk of ischemic strokeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-3692&volume=132&issue=1&spage=44&epage=9&date=2007&atitle=Transient+Atrial+Fibrillation+Complicating+Acute+Inferior+Myocardial+Infarction:+Implications+for+Future+Risk+of+Ischemic+Stroke.en_HK
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authoritySiu, CW=rp00534en_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1378/chest.06-2733en_HK
dc.identifier.pmid17400657-
dc.identifier.scopuseid_2-s2.0-34447572670en_HK
dc.identifier.hkuros126523en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34447572670&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume132en_HK
dc.identifier.issue1en_HK
dc.identifier.spage44en_HK
dc.identifier.epage49en_HK
dc.identifier.eissn1931-3543-
dc.identifier.isiWOS:000248140600011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridSiu, CW=7006550690en_HK
dc.identifier.scopusauthoridJim, MH=6603860344en_HK
dc.identifier.scopusauthoridHo, HH=7401465369en_HK
dc.identifier.scopusauthoridMiu, R=7801613455en_HK
dc.identifier.scopusauthoridLee, SWL=7601396808en_HK
dc.identifier.scopusauthoridLau, CP=35275317200en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK

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