Incidence of ischaemic stroke and mortality in patients with acute coronary syndrome and first-time detected atrial fibrillation: a nationwide study
Authors' conclusion
In patients with ACS, first-time detected AF appeared to be at least as strongly associated with the 1-year rates of ischaemic stroke, mortality, and bleeding as compared with patients with a history of AF.
Study context
- Population
- Patients surviving a first-time admission with acute coronary syndrome (ACS), Denmark, 2000–2018
- Participants
- 161,266 ACS survivors
- Exposure
- First-time detected atrial fibrillation (AF) vs history of AF vs no AF in ACS survivors
- No AFn = 135,878reference
- History of AFn = 18,961
- First-time detected AFn = 6,427
- Outcome
- Ischaemic stroke, death and bleeding
- Follow-up
- 1 year
Methodological detailsnationwide, Danish registries, multivariable adjusted Cox proportional hazards analysis
- Nationwide
- Danish registries
- Multivariable adjusted Cox proportional hazards analysis
Main finding
As reported in the abstract
Each group vs no AFHazard ratio (95% CI)
History of AFischaemic stroke; adjusted
1.38(1.22–1.56)
First-time detected AFischaemic stroke; adjusted
1.67(1.38–2.01)
History of AFmortality; adjusted
1.25(1.21–1.31)
First-time detected AFmortality; adjusted
1.52(1.43–1.62)
Observational data: associations, not effects.
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Bleeding · 1 yearHistory of AF vs No AF · adjusted | 1.22 (1.14–1.30) | |
| Bleeding · 1 yearFirst-time detected AF vs No AF · adjusted | 1.28 (1.15–1.43) | |
| 0.512Hazard ratio (log scale) |
Original publication
Incidence of ischaemic stroke and mortality in patients with acute coronary syndrome and first-time detected atrial fibrillation: a nationwide study. Eur Heart J. Published 3 September 2021. doi:10.
Summarised from the published abstract; every number is checked against it