Clinical profile and prognosis of patients with de-novo atrial fibrillation in acute coronary syndrome

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial fibrillation (AF) and ischemic cardiomyopathy share common risk factors. The aim of the study was to analyse clinical profile and mortality of patients presenting new-diagnosed AF in the context of acute coronary syndrome (ACS). Methods Retrospective, observational study of patients presenting with ACS in Acute Coronary Care Unit (ACCU) between 2011-2022. Baseline, demographic characteristics and clinical outcomes were studied. Results 3161 patients with ACS were admitted to the ACCU during this period, of whom 5.1% presented de-novo AF. The remaining percentage were patients without AF (86.8%) or with previously known AF (8.1%). 73.7% were male and 52.8% of the ACS presented with ST elevation. Baseline characteristics in both groups are shown in Table 1. Most frequent culprit vessel was the anterior descending artery in both groups, followed by right coronary artery. Severe bleeding was significantly more frequent in patients with de-novo AF (25.4% vs 9%, p<0.01). On univariate analysis, in-hospital all-cause mortality was significantly higher in the de-novo AF group (17.3% vs 5.8%, p<0.01), as well as in patients with previously known AF (10.9% p<0.01), compared to those without AF. In the multivariate analysis of all-cause mortality (Table 2) after adjusting for baseline characteristics, de-novo AF did not reach statistical significance. Conclusion De-novo AF is a relatively uncommon complication in ACS, identifying a high-risk profile patient with higher in-hospital mortality.