Risk factors and prognosis of new-onset atrial fibrillation in patients with acute myocardial infarction

Abstract

Objective To evaluate the risk factors associated with new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI) and to analyze their prognosis. Methods The 435 patients with AMI in the First Hospital of Jilin University from June 2017 to June 2018 were selected for analysis. NOAF was defined as atrial fibrillation detected on electrocardiogram at admission or during hospitalization. Demographic, clinical, laboratory, echocardiographic and coronary angiographic data were collected. Multivariate logistic regression analysis was used to determine the independent risk factors for NOAF and total mortality in patients with AMI. Results Among the 435 patients, 46 had NOAF, the incidence was 10.6%. Multivariate analysis showed that age > 60 years old (odds ratio [OR]=1.072, 95% confidence interval [CI]: 1.013-1.124, P=0.025), left ventricular ejection fraction 40 mm (OR=1.141, 95%CI: 1.037-1.261, P=0.012) were independent risk factors for NOAF. When both in-hospital and follow-up mortality were assessed collectively (overall mortality), NOAF was related to worse prognosis (15.2% vs. 7.7%, P=0.011). Multivariate analysis showed that age >60 years old, diabetes mellitus, NOAF and Killip Ⅲ/Ⅳ were independent risk factors for total mortality in patients with AMI (all P<0.05). Conclusions Old age, left ventricular systolic dysfunction (LVEF<40%) and increased left atrial diameter are risk factors for NOAF in patients with AMI, and patients with AMI with NOAF have a poor prognosis. Key words: Acute myocardial infarction; Atrial fibrillation; Risk factors; Prognosis