Prognostic Impact of New-Onset Atrial Fibrillation in Myocardial Infarction with and Without Improved Ejection Fraction
Authors' conclusion
The NOAF was associated with an increased risk of cardiovascular outcomes in AMI patients with impEF.
Study context
- Population
- Acute myocardial infarction (AMI) patients without prior AF, baseline left ventricular ejection fraction (LVEF) ≤ 40% and ≥1 follow-up LVEF measurement, February 2014–March 201867 (22.9%) developed new-onset atrial fibrillation (NOAF)
- Participants
- 293 patients
- Exposure
- NOAF vs no NOAF in AMI patients with impEF and with Persistently reduced EF (prEF)
- impEFn = 145
- Outcome
- MACE:
- CV death
- Heart failure (HF) hospitalization
- Follow-up
- Up to 5 years
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
MACE, NOAF vs no NOAF, by EF trajectory (subgroups)
NOAF vs no NOAFHazard ratio (95% CI)P value
impEF; multivariable adjusted
7.34(2.49–21.59)
P < 0.001prEF; multivariable adjusted
0.78(0.39–1.55)
P = 0.483Observational data: associations, not effects.
Further findings
| Outcome | Subdistribution HR (95% CI) | |
|---|---|---|
| MACE accounting for competing risk of all-cause deathNOAFvs no NOAFimpEF | 6.47 (2.32–18.09) | |
| MACE accounting for competing risk of all-cause deathNOAFvs no NOAFprEF | 0.79 (0.39–1.61) | |
| 0.050.21520Subdistribution hazard ratio (log scale) |
Independent predictors of post-MI impEF
| OR (95% CI) | P value | ||
|---|---|---|---|
| Higher heart rate | 0.84 (0.73–0.97) | P = 0.015 | |
| Prior MI | 0.25 (0.09–0.69) | P = 0.008 | |
| STEMI | 0.40 (0.21–0.77) | P = 0.006 | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Prognostic Impact of New-Onset Atrial Fibrillation in Myocardial Infarction with and Without Improved Ejection Fraction. ESC Heart Fail. Published 10 July 2024. doi:10.
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