Prognostic significance of new onset atrial fibrillation in acute coronary syndrome patients treated conservatively.

Abstract

BACKGROUND:

The purpose of this study was to assess the association between new onset of atrial fibrillation (AF) and in-hospital management and mortality in acute coronary syndrome patients admitted to hospitals without on-site invasive facilities.

METHODS:

We assessed data concerning in-hospital management and mortality of 24 patients with, and 977 patients without, new onset of AF from the Krakow Registry of Acute Coronary Syndromes database.

RESULTS:

Patients with new onset of AF were older and more likely to have diabetes, chronic obstructive pulmonary disease, cardiogenic shock and chest pain on admission, and a shorter time from the onset of symptoms to admission. These patients more frequently received glycoprotein IIb/IIIa inhibitors, thrombolytics, and were less likely to be treated with statins during their hospital stay. Risk of AF occurrence was lower in patients treated with statins (1.9% vs 5.2%; p = 0.021). Among patients treated conservatively, in-hospital mortality was higher in patients with new onset of AF (8.1% vs 33.3%; p = 0.001). Independent predictors of inhospital death in this group of patients were: new onset of AF, age, cardiogenic shock, chronic obstructive pulmonary disease, history of renal insufficiency, and discharge diagnosis.

CONCLUSIONS:

New onset of AF is associated with excessive in-hospital mortality in acute coronary syndrome patients staying on conservative treatment in community hospitals without on-site invasive facilities.

• Authors: Artur Dziewierz, Zbigniew Siudak, Tomasz Rakowski, Jacek Jakała, Jacek S Dubiel, Dariusz Dudek
• Journal: Cardiology journal (Cardiol J) Vol. 17 Issue 1 Pg. 57-64 ( 2010) ISSN: 1898-018X [Electronic] Poland
• PMID: 20104458 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Fibrinolytic Agents
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Platelet Glycoprotein GPIIb-IIIa Complex

Topics

• Acute Coronary Syndrome (complications, drug therapy, mortality)
• Age Factors
• Aged
• Aged, 80 and over
• Atrial Fibrillation (etiology, mortality, prevention & control)
• Female
• Fibrinolytic Agents (therapeutic use)
• Hospital Mortality
• Hospitalization
• Hospitals, Community
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Male
• Patient Admission
• Platelet Glycoprotein GPIIb-IIIa Complex (antagonists & inhibitors)
• Prognosis
• Prospective Studies
• Pulmonary Disease, Chronic Obstructive (complications)
• Renal Insufficiency (complications)
• Shock, Cardiogenic (complications)
• Time Factors