Clinical characteristics, treatment and complications of patients with acute myocardial infarction and atrial fibrillation:

Analysis of 5,708 cases from the national registry ARGEN-IAM-ST

Abstract

Background: Atrial fibrillation (AF) is the most common type of sustained arrhythmia observed in acute myocardial infarction with persistent ST-segment elevation (STEMI). It can be preexistent or part of a complication, which often allows the identification of groups in higher risk. This study was designed to evaluate the clinical characteristics, therapeutic management and in-hospital prognosis in the aforementioned population of patients. Methods: Patients included in the national registry ARGEN-IAM-ST were studied, identifying those with AF. The treatments provided and in-hospital prognosis were assessed. Results: A total of 5,708 patients participated, of whom 5.7% (n=323) constituted the “AF group”. Of these, 44% presented with AF from the start and the remaining 56% developed some event during hospitalization. The patients in the AF group were older (68.7 years [60-76.5] vs. 60 years [53-68]; p<0.001), and had a higher prevalence of hypertension (73.4% vs. 58%; p<0.001) and coronary revascularization or infarction (18% vs. 13%; p: 0.008). They also received less treatment with aspirin (88.4% vs. 96.5%; p<0.001) and strong antiplatelet agents (12.7% vs. 25.5%; p<0.001). In these patients, higher rates of stroke (3.1% vs. 0.8%; p<0.001), bleeding (8.7% vs. 2.4%; p<0.001) and in-hospital mortality (22.9% vs. 7.8%; p<0,001) were observed. Conclusions: In this population of patients with STEMI, the subjects of the AF subgroup were older, had more comorbidities, and were associated with higher rates of in-hospital events.