TY - JOUR
T1 - Incidence of ischaemic stroke and mortality in patients with acute coronary syndrome and first-time detected atrial fibrillation
T2 - a nationwide study
AU - Petersen, Jeppe Kofoed
AU - Haider Butt, Jawad
AU - Yafasova, Adelina
AU - Torp-Pedersen, Christian
AU - Sørensen, Rikke
AU - Kruuse, Christina
AU - Vinding, Naja Emborg
AU - Gundlund, Anna
AU - Køber, Lars
AU - Loldrup Fosbøl, Emil
AU - Østergaard, Lauge
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: [email protected].
PY - 2021/11/21
Y1 - 2021/11/21
N2 - AIMS : The aim of this study was to examine contemporary data on the 1-year prognosis of patients surviving acute coronary syndrome (ACS) and concomitant first-time detected atrial fibrillation (AF).METHODS AND RESULTS: Using Danish nationwide registries, we identified all patients surviving a first-time admission with ACS from 2000 to 2018 and grouped them into (i) those without AF prior to or during ACS; (ii) those with a history of AF; and (iii) those with first-time detected AF during admission with ACS. With 1 year of follow-up, rates of ischaemic stroke, death, and bleeding were compared between study groups using multivariable adjusted Cox proportional hazards analysis. We included 161 266 ACS survivors: 135 878 (84.2%) without AF, 18 961 (11.8%) with history of AF, and 6427 (4.0%) with first-time detected AF at admission with ACS. Compared to those without AF, the adjusted 1-year rates of outcomes were as follows: ischaemic stroke [hazard ratio (HR) 1.38 (95% CI 1.22-1.56) for patients with history of AF and HR 1.67 (95% CI 1.38-2.01) for patients with first-time detected AF]; mortality [HR 1.25 (95% CI 1.21-1.31) for patients with history of AF and HR 1.52 (95% CI 1.43-1.62) for patients with first-time detected AF]; and bleeding [HR 1.22 (95% CI 1.14-1.30) for patients with history of AF and HR 1.28 (95% CI 1.15-1.43) for patients with first-time detected AF].CONCLUSION : In patients with ACS, first-time detected AF appeared to be at least as strongly associated with the 1-year rates of ischaemic stroke, mortality, and bleeding as compared with patients with a history of AF.
AB - AIMS : The aim of this study was to examine contemporary data on the 1-year prognosis of patients surviving acute coronary syndrome (ACS) and concomitant first-time detected atrial fibrillation (AF).METHODS AND RESULTS: Using Danish nationwide registries, we identified all patients surviving a first-time admission with ACS from 2000 to 2018 and grouped them into (i) those without AF prior to or during ACS; (ii) those with a history of AF; and (iii) those with first-time detected AF during admission with ACS. With 1 year of follow-up, rates of ischaemic stroke, death, and bleeding were compared between study groups using multivariable adjusted Cox proportional hazards analysis. We included 161 266 ACS survivors: 135 878 (84.2%) without AF, 18 961 (11.8%) with history of AF, and 6427 (4.0%) with first-time detected AF at admission with ACS. Compared to those without AF, the adjusted 1-year rates of outcomes were as follows: ischaemic stroke [hazard ratio (HR) 1.38 (95% CI 1.22-1.56) for patients with history of AF and HR 1.67 (95% CI 1.38-2.01) for patients with first-time detected AF]; mortality [HR 1.25 (95% CI 1.21-1.31) for patients with history of AF and HR 1.52 (95% CI 1.43-1.62) for patients with first-time detected AF]; and bleeding [HR 1.22 (95% CI 1.14-1.30) for patients with history of AF and HR 1.28 (95% CI 1.15-1.43) for patients with first-time detected AF].CONCLUSION : In patients with ACS, first-time detected AF appeared to be at least as strongly associated with the 1-year rates of ischaemic stroke, mortality, and bleeding as compared with patients with a history of AF.
KW - Acute Coronary Syndrome/epidemiology
KW - Atrial Fibrillation/epidemiology
KW - Brain Ischemia/epidemiology
KW - Humans
KW - Incidence
KW - Ischemic Stroke
KW - Registries
KW - Risk Factors
KW - Stroke/epidemiology
KW - Myocardial infarction
KW - Atrial fibrillation
KW - Bleeding
KW - Acute coronary syndrome
KW - Unstable angina pectoris
KW - Ischaemic stroke
UR - http://www.scopus.com/inward/record.url?scp=85119984599&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehab575
DO - 10.1093/eurheartj/ehab575
M3 - Journal article
C2 - 34477838
SN - 0195-668X
VL - 42
SP - 4553
EP - 4561
JO - European Heart Journal
JF - European Heart Journal
IS - 44
M1 - ehab575
ER -