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Atrial Fibrillation and Mortality in Patients with Acute Myocardial Infarction: A Systematic Overview and Meta-analysis

  • Invasive Electrophysiology and Pacing (J Singh, Section Editor)
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Abstract

Atrial fibrillation (AF) confers an increased risk of mortality in patients hospitalized for acute myocardial infarction (AMI). However, it is unclear whether new-onset and preexisting AF portend a different risk. We extracted data from studies that evaluated in-hospital mortality in patients with AMI and included information on cardiac rhythm. Overall, the risk of mortality was higher in patients with AF than in those in sinus rhythm (OR 2.00, 95 % CI: 1.93–2.08; P < 0.0001). Compared with patients who remained in sinus rhythm, the risk of death was increased in patients with new AF certain (sinus rhythm on admission, new AF during hospitalization, and history of no evidence of prior AF; OR 3.38, 95 % CI: 2.98–3.83; P < 0.0001), new AF uncertain (sinus rhythm on admission, AF during hospitalization, but no clear information about previous history of AF; OR 1.90, 95 % CI:1.83–1.98; P < 0.0001), and permanent AF (AF before and during hospitalization; OR 2.01, 95 % CI:1.70–2.38;P < 0.0001). In a meta-regression analysis, the risk of death was 87 % higher in patients with new AF certain than in those with permanent AF (P = 0.013) or AF uncertain (P = 0.003), and not dissimilar in patients with new AF uncertain and permanent AF (P = 0.706).

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Acknowledgment

This study was funded in part by the Fondazione Umbra Cuore e Ipertensione - ONLUS, Perugia, Italy.

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Authors and Affiliations

  1. Section of Cardiology, Hospital “Media Valle del Tevere,” AUSL 2, Umbria, Italy

    Fabio Angeli

  2. Department of Internal Medicine, University of Perugia, Perugia, Italy

    Gianpaolo Reboldi

  3. Department of Cardiology, University of Perugia, Perugia, Italy

    Marta Garofoli, Elisa Ramundo, Cristina Poltronieri, Giovanni Mazzotta & Giuseppe Ambrosio

  4. Department of Internal Medicine, Hospital of Assisi, Assisi, Italy

    Paolo Verdecchia

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  1. Fabio Angeli
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Angeli, F., Reboldi, G., Garofoli, M. et al. Atrial Fibrillation and Mortality in Patients with Acute Myocardial Infarction: A Systematic Overview and Meta-analysis. Curr Cardiol Rep 14, 601–610 (2012). https://doi.org/10.1007/s11886-012-0289-3

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