New-Onset Atrial Fibrillation in Acute Myocardial Infarction Is a Different Phenomenon than Other Pre-Existing Types of That Arrhythmia.
Monika Raczkowska-GolankoKrzysztof MłodzińskiGrzegorz RaczakMarcin GruchałaLudmiła Daniłowicz-SzymanowiczPublished in: Journal of clinical medicine (2022)
(1) Background: Atrial fibrillation (AF) in acute myocardial infarction (AMI) could worsen the prognosis. Yet, there is no definitive answer to whether new-onset AF (NOAF) is a more aggravating diagnosis than other types of that arrhythmia. The purpose of our study was to compare in-hospital clinical course and outcomes of NOAF patients contrary to patients with other pre-existing types of AF. (2) Methods: AMI patients hospitalized in the high-volume cardiological center within 2017-2018 were included in the study. NOAF was noticed in 106 (11%) patients, 95 (10%) with an AF history and AF during AMI formed the AF group, 60 (6%) with an AF history but without AF during AMI constituted the Prior-AF group, and 693 (73%) patients were without an AF before and during AMI. Medical history, routinely monitored clinical parameters, and in-hospital outcomes were analyzed between the groups. (3) Results: NOAF patients, contrary to others, initially had the highest high-sensitivity troponin I (hsTnI), B-type natriuretic peptide (BNP), C-reactive protein (CRP), and glucose levels, and the lowest potassium concentration, with the worst profile of changes for that parameter within the first four days of hospitalization. NOAF patients had the highest rate of ST-elevated AMI (40%), the longest hospitalization ( p < 0.001), and the highest in-hospital mortality ( p < 0.001). Not NOAF, but other AF groups (AF and Prior-AF groups) were more burdened with the previous comorbidities. (4) Conclusions: NOAF could be a distinct phenomenon in AMI patients, identifying those with the worst clinical in-hospital course and outcomes as compared to other types of AF.
Keyphrases
- atrial fibrillation
- acute myocardial infarction
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- percutaneous coronary intervention
- healthcare
- prognostic factors
- type diabetes
- peritoneal dialysis
- left ventricular
- patient reported outcomes
- insulin resistance
- blood glucose
- rectal cancer
- acute coronary syndrome
- mitral valve
- locally advanced
- glycemic control