TY - JOUR
T1 - Trends in the Incidence and In-Hospital Outcomes of Patients With Atrial Fibrillation Complicated by Non-ST-Segment Elevation Myocardial Infarction
AU - Ogunbayo, Gbolahan O.
AU - Messerli, Adrian W.
AU - Ha, Le Dung
AU - Elbadawi, Ayman
AU - Olorunfemi, Odunayo
AU - Darrat, Yousef
AU - Guglin, Maya
AU - Okwechime, Remi
AU - Akanya, Deborah
AU - Abdel-Latif, Ahmed
AU - Smyth, Susan S.
AU - Elayi, Claude S.
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Atrial fibrillation (AF) can present with non-ST-segment elevation myocardial infarction (NSTEMI). The incidence, characteristics, outcomes, and treatment of this subgroup of patients with AF remains poorly studied. Using data from the National Inpatient Sample database, we (1) compared baseline characteristics of patients with AF with/without NSTEMI, (2) evaluated their outcomes and associated trends over the study period (2004-2013), and (3) evaluated revascularization (by percutaneous coronary intervention or coronary artery bypass graft [CABG]) and the impact on patient outcomes. Of the 3 923 436 patients admitted with a primary diagnosis of AF, 47 785 (1.2%) had a secondary diagnosis of NSTEMI. In this subgroup with AF and NSTEMI, there was a significant trend toward a decrease in mortality (P =.002), stroke (P <.001), and gastrointestinal bleeding (P <.001) during the study period. Compared to unrevascularized patients, revascularized patients were more likely to be younger (72.2 ± 10.2 vs 77.0 ± 11.8 years old, P <.001), male (57.8 vs 42.7%, P <.001), and had a much higher incidence of coronary risk factors. Revascularization was associated with increased survival in multivariable analysis (odds ratio: 0.562, 95% confidence interval: 0.334-0.946, P =.03). In conclusion, among patients admitted with AF, 1.2% were diagnosed with NSTEMI. A minority of patients with AF and NSTEMI underwent revascularization and had better in-hospital outcomes.
AB - Atrial fibrillation (AF) can present with non-ST-segment elevation myocardial infarction (NSTEMI). The incidence, characteristics, outcomes, and treatment of this subgroup of patients with AF remains poorly studied. Using data from the National Inpatient Sample database, we (1) compared baseline characteristics of patients with AF with/without NSTEMI, (2) evaluated their outcomes and associated trends over the study period (2004-2013), and (3) evaluated revascularization (by percutaneous coronary intervention or coronary artery bypass graft [CABG]) and the impact on patient outcomes. Of the 3 923 436 patients admitted with a primary diagnosis of AF, 47 785 (1.2%) had a secondary diagnosis of NSTEMI. In this subgroup with AF and NSTEMI, there was a significant trend toward a decrease in mortality (P =.002), stroke (P <.001), and gastrointestinal bleeding (P <.001) during the study period. Compared to unrevascularized patients, revascularized patients were more likely to be younger (72.2 ± 10.2 vs 77.0 ± 11.8 years old, P <.001), male (57.8 vs 42.7%, P <.001), and had a much higher incidence of coronary risk factors. Revascularization was associated with increased survival in multivariable analysis (odds ratio: 0.562, 95% confidence interval: 0.334-0.946, P =.03). In conclusion, among patients admitted with AF, 1.2% were diagnosed with NSTEMI. A minority of patients with AF and NSTEMI underwent revascularization and had better in-hospital outcomes.
KW - atrial fibrillation
KW - non-ST elevation myocardial infarction
KW - revascularization
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U2 - 10.1177/0003319718801087
DO - 10.1177/0003319718801087
M3 - Article
C2 - 30231624
AN - SCOPUS:85060214135
SN - 0003-3197
VL - 70
SP - 317
EP - 324
JO - Angiology
JF - Angiology
IS - 4
ER -