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Increased risk of sudden and non-sudden cardiovascular death in patients with atrial fibrillation/flutter following acute myocardial infarction.
Eur Heart J. 2006 Feb; 27(3):290-5.EH

Abstract

AIMS

Atrial fibrillation (AF) is a common complication in patients with acute myocardial infarction and is associated with an increase in the risk of death. The excess mortality associated with AF complicating acute myocardial infarction has not been studied in detail. Observations indicate that AF facilitates induction of ventricular arrhythmias, which may increase the risk of sudden cardiovascular death (SCD). A close examination of the mode of death could potentially provide useful knowledge to guide further investigations and treatments.

METHODS AND RESULTS

We analysed the relation between AF/atrial flutter (AFL) and modes of death in 5983 consecutive patients discharged alive after an acute myocardial infarction screened in the TRAndolapril Cardiac Evaluation registry. This cohort of patients with an enzyme-verified acute myocardial infarction was admitted to 27 centres in 1990-92. Survival status was obtained 2 years after screening of the last patient. An independent endpoint committee assessed the modes of death. Left ventricular ejection fraction was determined in all the screened patients and information about presence or absence of AF/AFL was prospectively collected. Sustained or paroxysmal AF/AFL was observed in 1149 patients (19%) during hospitalization. During follow-up, 1659 patients (34%) died: 482 (50%) patients with AF/AFL and 1177 (30%) patients without AF/AFL, P<0.001. SCD occurred in 536, non-SCD occurred in 725, and 398 died of non-cardiovascular causes (includes 142 unclassifiable cases). The adjusted risk ratio of AF/AFL for total mortality was 1.33 (95% CI: 1.19-1.49; P<0.0001) and the risk ratio for SCD was 1.31 (95% CI: 1.07-1.60; P<0.009). The adjusted risk ratio of AF/AFL for non-SCD was 1.43 (95% CI: 1.21-1.70; P<0.0001).

CONCLUSION

The excess mortality observed in patients with AF/AFL following acute myocardial infarction is due to a significant increase in both SCD and non-SCD.

Authors+Show Affiliations

Department of Cardiology Y, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark. odplc@mail.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16267070

Citation

Pedersen, Ole Dyg, et al. "Increased Risk of Sudden and Non-sudden Cardiovascular Death in Patients With Atrial Fibrillation/flutter Following Acute Myocardial Infarction." European Heart Journal, vol. 27, no. 3, 2006, pp. 290-5.
Pedersen OD, Abildstrøm SZ, Ottesen MM, et al. Increased risk of sudden and non-sudden cardiovascular death in patients with atrial fibrillation/flutter following acute myocardial infarction. Eur Heart J. 2006;27(3):290-5.
Pedersen, O. D., Abildstrøm, S. Z., Ottesen, M. M., Rask-Madsen, C., Bagger, H., Køber, L., & Torp-Pedersen, C. (2006). Increased risk of sudden and non-sudden cardiovascular death in patients with atrial fibrillation/flutter following acute myocardial infarction. European Heart Journal, 27(3), 290-5.
Pedersen OD, et al. Increased Risk of Sudden and Non-sudden Cardiovascular Death in Patients With Atrial Fibrillation/flutter Following Acute Myocardial Infarction. Eur Heart J. 2006;27(3):290-5. PubMed PMID: 16267070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of sudden and non-sudden cardiovascular death in patients with atrial fibrillation/flutter following acute myocardial infarction. AU - Pedersen,Ole Dyg, AU - Abildstrøm,Steen Z, AU - Ottesen,Michael M, AU - Rask-Madsen,Christian, AU - Bagger,Henning, AU - Køber,Lars, AU - Torp-Pedersen,Christian, AU - ,, Y1 - 2005/11/02/ PY - 2005/11/4/pubmed PY - 2006/7/26/medline PY - 2005/11/4/entrez SP - 290 EP - 5 JF - European heart journal JO - Eur Heart J VL - 27 IS - 3 N2 - AIMS: Atrial fibrillation (AF) is a common complication in patients with acute myocardial infarction and is associated with an increase in the risk of death. The excess mortality associated with AF complicating acute myocardial infarction has not been studied in detail. Observations indicate that AF facilitates induction of ventricular arrhythmias, which may increase the risk of sudden cardiovascular death (SCD). A close examination of the mode of death could potentially provide useful knowledge to guide further investigations and treatments. METHODS AND RESULTS: We analysed the relation between AF/atrial flutter (AFL) and modes of death in 5983 consecutive patients discharged alive after an acute myocardial infarction screened in the TRAndolapril Cardiac Evaluation registry. This cohort of patients with an enzyme-verified acute myocardial infarction was admitted to 27 centres in 1990-92. Survival status was obtained 2 years after screening of the last patient. An independent endpoint committee assessed the modes of death. Left ventricular ejection fraction was determined in all the screened patients and information about presence or absence of AF/AFL was prospectively collected. Sustained or paroxysmal AF/AFL was observed in 1149 patients (19%) during hospitalization. During follow-up, 1659 patients (34%) died: 482 (50%) patients with AF/AFL and 1177 (30%) patients without AF/AFL, P<0.001. SCD occurred in 536, non-SCD occurred in 725, and 398 died of non-cardiovascular causes (includes 142 unclassifiable cases). The adjusted risk ratio of AF/AFL for total mortality was 1.33 (95% CI: 1.19-1.49; P<0.0001) and the risk ratio for SCD was 1.31 (95% CI: 1.07-1.60; P<0.009). The adjusted risk ratio of AF/AFL for non-SCD was 1.43 (95% CI: 1.21-1.70; P<0.0001). CONCLUSION: The excess mortality observed in patients with AF/AFL following acute myocardial infarction is due to a significant increase in both SCD and non-SCD. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/16267070/Increased_risk_of_sudden_and_non_sudden_cardiovascular_death_in_patients_with_atrial_fibrillation/flutter_following_acute_myocardial_infarction_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehi629 DB - PRIME DP - Unbound Medicine ER -