Atrial Fibrillation Type Affects Outcomes for Heart Condition

Study suggests previous onset associated with higher long-term mortality

FRIDAY, Dec. 11 (HealthDay News) -- Patients with acute coronary syndromes who develop new-onset atrial fibrillation have worse short-term outcomes, while a history of atrial fibrillation is associated with higher long-term mortality, according to a study in the Nov. 15 issue of the American Journal of Cardiology.

Dennis H. Lau, from the University of Adelaide in Australia, and colleagues examined factors and outcomes associated with atrial fibrillation in 3,393 patients with acute coronary syndromes (ST-segment elevation myocardial infarction, high-risk non-ST-segment elevation acute coronary syndromes, and intermediate-risk non-ST-segment elevation acute coronary syndromes).

The researchers found that 4.4 percent of patients developed new-onset atrial fibrillation and 11.4 percent had a history of atrial fibrillation. New onset atrial fibrillation was more common, while previous atrial fibrillation was less common in patients with ST-segment elevation myocardial infarction than in the other two groups. New onset atrial fibrillation was associated with left main coronary artery disease leading to more surgical revascularization. These patients also had more adverse in-hospital outcomes and a worse long-term composite outcome (hazard ratio, 1.66). A history of atrial fibrillation was associated with higher long-term mortality (hazard ratio, 1.42).

"In conclusion, new-onset atrial fibrillation was associated with worse short-term outcomes and previous atrial fibrillation was associated with greater mortality even at long-term follow-up," Lau and colleagues conclude.

Sanofi-Aventis and Australia Pty Ltd. sponsored the data collection for the patient registry.

Abstract
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