Atrial fibrillation in patients hospitalized with acute myocardial infarction: analysis of the china acute myocardial infarction (CAMI) registry
Tóm tắt
The incidence, clinical outcomes and antithrombotic treatment spectrum of atrial fibrillation (AF) in patients hospitalized with acute myocardial infarction (AMI) have not been well studied in Chinese population. Twenty-six thousand five hundred ninety-two consecutive patients diagnosed with AMI were enrolled in CAMI registry from January 2013 to September 2014. After excluding 343 patients with uncertain AF status and 1,591 patients transferred out during hospitalization, 24,658 patients were finally included in this study and involved in analysis. In the CAMI registry, 740 (3.0%) patients were recorded with AF prevalence during hospitalization. Higher-risk baseline clinical profile was observed in patients with AF. These patients were less likely to receive reperfusion/revascularization than those without AF. The in-hospital mortality (including death and treatment withdrawal) was significantly higher in patients with AF than that of without AF (25.2% vs. 7.2%, respectively; p < 0.01). The case of composite of adverse events was similar, which included death, treatment withdrawal, re-infarction, heart failure or stroke (42.1% vs. 16.0%, p <0.01). In multivariate logistic regression analysis, AF was an independent predictor for in-hospital mortality (odds ratio, 1.88; 95% confidence interval: 1.27–2.78) and the composite of adverse events (odds ratio, 2.11; 95% CI: 1.63–2.72). Only 5.1% of patients with AF were treated with warfarin, and 1.7% were treated with both warfarin and dual antiplatelet therapy. The analysis was based on the CAMI registry in China. The patients hospitalized for AMI who developed AF were at significantly higher risk for in-hospital mortality and other adverse events. However, the anticoagulants including warfarin have been largely underused post hospital discharge. Clinical Trial Registration:
Identifier: NCT01874691
.
Tài liệu tham khảo
Schmitt J, Duray G, Gersh BJ, Hohnloser SH. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. Eur Heart J. 2009;30(9):1038–45.
Lopes RD, Pieper KS, Horton JR, Al-Khatib SM, Newby LK, Mehta RH, et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart. 2008;94(7):867–73.
Gonzalez-Pacheco H, Marquez MF, Arias-Mendoza A, Alvarez-Sangabriel A, Eid-Lidt G, Gonzalez-Hermosillo A, et al. Clinical features and in-hospital mortality associated with different types of atrial fibrillation in patients with acute coronary syndrome with and without ST elevation. J Cardiol. 2015;66(2):148–54.
Hersi A, Alhabib KF, Alsheikh-Ali AA, Sulaiman K, Alfaleh HF, Alsaif S, et al. Prognostic significance of prevalent and incident atrial fibrillation among patients hospitalized with acute coronary syndrome: findings from the Gulf RACE-2 Registry. Angiology. 2012;63(6):466–71.
Lau DH, Huynh LT, Chew DP, Astley CM, Soman A, Sanders P. Prognostic impact of types of atrial fibrillation in acute coronary syndromes. Am J Cardiol. 2009;104(10):1317–23.
Jabre P, Roger VL, Murad MH, Chamberlain AM, Prokop L, Adnet F, et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis. Circulation. 2011;123(15):1587–93.
Podolecki T, Lenarczyk R, Kowalczyk J, Kurek T, Boidol J, Chodor P, et al. Effect of type of atrial fibrillation on prognosis in acute myocardial infarction treated invasively. Am J Cardiol. 2012;109(12):1689–93.
Rene AG, Genereux P, Ezekowitz M, Kirtane AJ, Xu K, Mehran R, et al. Impact of atrial fibrillation in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention (from the HORIZONS-AMI [Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction] trial). Am J Cardiol. 2014;113(2):236–42.
McManus DD, Huang W, Domakonda KV, Ward J, Saczysnki JS, Gore JM, et al. Trends in atrial fibrillation in patients hospitalized with an acute coronary syndrome. Am J Med. 2012;125(11):1076–84.
Eldar M, Canetti M, Rotstein Z, Boyko V, Gottlieb S, Kaplinsky E, et al. Significance of paroxysmal atrial fibrillation complicating acute myocardial infarction in the thrombolytic era. SPRINT Thrombolytic Surv Groups Circ. 1998;97(10):965–70.
Kinjo K, Sato H, Ohnishi Y, Hishida E, Nakatani D, Mizuno H, et al. Prognostic significance of atrial fibrillation/atrial flutter in patients with acute myocardial infarction treated with percutaneous coronary intervention. Am J Cardiol. 2003;92(10):1150–4.
Asanin M, Perunicic J, Mrdovic I, Matic M, Vujisic-Tesic B, Arandjelovic A, et al. Prognostic significance of new atrial fibrillation and its relation to heart failure following acute myocardial infarction. Eur J Heart Fail. 2005;7(4):671–6.
Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC guidelines for the management of atrial fibrillation: an update of the 2010 ESC guidelines for the management of atrial fibrillation. Developed with the special contribution of the european heart rhythm association. Eur Heart J. 2012;33(21):2719–47.
Faxon DP, Eikelboom JW, Berger PB, Holmes DR, Bhatt DL, Moliterno DJ, et al. Consensus document: antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting. North-American perspect Thromb Haemost. 2011;106(4):572–84.
Chamberlain AM, Gersh BJ, Mills RM, Klaskala W, Alonso A, Weston SA, et al. Antithrombotic strategies and outcomes in acute coronary syndrome with atrial fibrillation. Am J Cardiol. 2015;115(8):1042–8.
Maier B, Hegenbarth C, Theres H, Schoeller R, Schuehlen H, Behrens S. Antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome in the real world: data from the berlin AFibACS registry. Cardiol J. 2014;21(5):465–73.
Lopes RD, Li L, Granger CB, Wang TY, Foody JM, Funk M, et al. Atrial fibrillation and acute myocardial infarction: antithrombotic therapy and outcomes. Am J Med. 2012;125(9):897–905.
Chen ZM, Jiang LX, Chen YP, Xie JX, Pan HC, Peto R, et al. Addition of clopidogrel to aspirin in 45,852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366(9497):1607–21.
Gao R, Patel A, Gao W, Hu D, Huang D, Kong L, et al. Prospective observational study of acute coronary syndromes in China: practice patterns and outcomes. Heart. 2008;94(5):554–60.
Xu H, Li W, Yang J, Wiviott SD, Sabatine MS, Peterson ED, et al. The China Acute Myocardial Infarction (CAMI) Registry: A national long-term registry-research-education integrated platform for exploring acute myocardial infarction in China. Am Heart J. 2016;175(5):193-201.e3
Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, et al. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. 2000;101(9):969–74.
Fang MC, Chen J, Rich MW. Atrial fibrillation in the elderly. Am J Med. 2007;120(6):481–7.
Goldberg RJ, Yarzebski J, Lessard D, Wu J, Gore JM. Recent trends in the incidence rates of and death rates from atrial fibrillation complicating initial acute myocardial infarction: a community-wide perspective. Am Heart J. 2002;143(3):519–27.
Anand K, Mooss AN, Hee TT, Mohiuddin SM. Meta-analysis inhibition of renin-angiotensin system prevents new-onset atrial fibrillation. Am Heart J. 2006;152(2):217–22.
Ehrlich JR, Hohnloser SH, Nattel S. Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence. Eur Heart J. 2006;27(5):512–8.
Fox KA, Anderson Jr FA, Dabbous OH, Steg PG, Lopez-Sendon J, Van de Werf F, et al. Intervention in acute coronary syndromes: do patients undergo intervention on the basis of their risk characteristics? The Global Registry of Acute Coronary Events (GRACE). Heart. 2007;93(2):177–82.
Lamberts M, Gislason GH, Olesen JB, Kristensen SL, Schjerning Olsen AM, Mikkelsen A, et al. Oral anticoagulation and antiplatelets in atrial fibrillation patients after myocardial infarction and coronary intervention. J Am Coll Cardiol. 2013;62(11):981–9.
Lamberts M, Olesen JB, Ruwald MH, Hansen CM, Karasoy D, Kristensen SL, et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study. Circulation. 2012;126(10):1185–93.
Du X, Gao R, Turnbull F, Wu Y, Rong Y, Lo S, et al. Hospital quality improvement initiative for patients with acute coronary syndromes in China: a cluster randomized, controlled trial. Circ Cardiovasc Qual Outcomes. 2014;7(2):217–26.
Ranasinghe I, Rong Y, Du X, Wang Y, Gao R, Patel A, et al. System barriers to the evidence-based care of acute coronary syndrome patients in China: qualitative analysis. Circ Cardiovasc Qual Outcomes. 2014;7(2):209–16.
Lancet T. Chinese doctors are under threat. Lancet. 2010;376(9742):657.
Campo G, Guastaroba P, Marzocchi A, Santarelli A, Varani E, Vignali L, et al. Impact of copd on long-term outcome after st-segment elevation myocardial infarction receiving primary percutaneous coronary intervention. Chest. 2013;144(3):750–7.
Campo G, Saia F, Guastaroba P, Marchesini J, Varani E, Manari A, et al. Prognostic impact of hospital readmissions after primary percutaneous coronary intervention. Arch Intern Med. 2011;171(21):1948–9.
Campo G, Saia F, Percoco G, et al. Long-term outcome after drug eluting stenting in patients with ST-segment elevation myocardial infarction: data from the REAL registry. Int J Cardiol. 2010;140(2):154–60.
Percoco G, Manari A, Guastaroba P, et al. Safety and long-term efficacy of sirolimus eluting stent in ST-elevation acute myocardial infarction: the REAL (Registro REgionale AngiopLastiche Emilia-Romagna) registry. Cardiovasc Drugs Ther. 2006;20(1):63–8.
Valgimigli M, Saia F, Guastaroba P, et al. Transradial versus transfemoral intervention for acute myocardial infarction : a propensity score-adjusted and -matched analysis from the REAL (REgistro regionale AngiopLastiche dell’Emilia-romagna) multicenter registry. J Am Coll Cardiol Intv. 2012;5(1):23–35.