Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke

Background: Atrial fibrillation (AF) often complicates ST elevation acute myocardial infarction (STEMI), with associated risks including stroke and mortality. Anticoagulation therapy for these patients and AF prognosis remains controversial. The aim was to evaluate long-term prognosis of STEMI patie...

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Autores: Martínez Membrive, María José, Subirana Cachinero, Isaac, Fadeuilhe, Edgar, Rueda, Ferran, Carreras-Mora, José, Oliveras, Teresa, Giralt Borrell, Teresa, Labata, Carlos, Ferrer, Marc, El Ouaddi, Nabil, Montero, Santiago, Elosua Llanos, Roberto, Ribas Barquet, Núria, Bayés-Genís, Antoni, García-García, Cosme
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/69353
Acceso en línea:http://hdl.handle.net/10230/69353
http://dx.doi.org/10.1093/ehjacc/zuae072
Access Level:acceso abierto
Palabra clave:STEMI
Atrial fibrillation
Prognosis
Stroke
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spelling Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk strokeMartínez Membrive, María JoséSubirana Cachinero, IsaacFadeuilhe, EdgarRueda, FerranCarreras-Mora, JoséOliveras, TeresaGiralt Borrell, TeresaLabata, CarlosFerrer, MarcEl Ouaddi, NabilMontero, SantiagoElosua Llanos, RobertoRibas Barquet, NúriaBayés-Genís, AntoniGarcía-García, CosmeSTEMIAtrial fibrillationPrognosisStrokeBackground: Atrial fibrillation (AF) often complicates ST elevation acute myocardial infarction (STEMI), with associated risks including stroke and mortality. Anticoagulation therapy for these patients and AF prognosis remains controversial. The aim was to evaluate long-term prognosis of STEMI patients complicated with AF in the acute phase. Methods: We performed a retrospective analysis on a prospective register involving 4,184 patients admitted for STEMI to the intensive cardiac care unit of 2 tertiary centres from 2007 to 2015. Patients with pre-existing permanent AF were excluded. Out of these, 269 (6.4%) patients developed AF within the first 48 hours after STEMI and were matched with a control group based on age and left ventricular ejection fraction (LVEF). Results: After matching, a total of 470 patients were included (n=235, AF-STEMI; n=235, control group). Mean age 69.0 years, and 31.7% women. No differences were found in gender, cardiovascular risk factors or ischemic heart disease. AF-STEMI patients experienced more sustained ventricular tachycardia, advanced atrioventricular block, heart failure, and cardiogenic shock. In-hospital mortality was also higher in AF-STEMI patients (11.9% vs 7.2%, p=0.008). After 10-years follow-up, the AF-STEMI group had remained with higher mortality (50.5% vs. 36.2%; p=0.003) and a greater recurrence of AF (44.2% vs. 14.7%; p<0.001), without differences in stroke incidence (10.1% vs. 9.3%). Conclusions: As a conclusion, patients with AF complicating STEMI have higher rates of heart failure, cardiogenic shock, and in-hospital mortality. After a 10-year follow-up, they exhibit a high risk of AF recurrence and mortality, with no significant differences in stroke incidence.Oxford University Press202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/69353http://dx.doi.org/10.1093/ehjacc/zuae072reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésEur Heart J Acute Cardiovasc Care. 2025 Apr 26;14(4):214-22© Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in European heart journal. Acute cardiovascular care following peer review. The version of record Martínez Membrive MJ, Subirana I, Fadeuilhe E, Rueda F, Carreras-Mora J, Oliveras T, et al. Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke. Eur Heart J Acute Cardiovasc Care. 2024 Jun 3:zuae072. DOI: 10.1093/ehjacc/zuae072 is available online at: http://dx.doi.org/10.1093/ehjacc/zuae072info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/693532026-06-12T07:21:37Z
dc.title.none.fl_str_mv Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
title Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
spellingShingle Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
Martínez Membrive, María José
STEMI
Atrial fibrillation
Prognosis
Stroke
title_short Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
title_full Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
title_fullStr Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
title_full_unstemmed Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
title_sort Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke
dc.creator.none.fl_str_mv Martínez Membrive, María José
Subirana Cachinero, Isaac
Fadeuilhe, Edgar
Rueda, Ferran
Carreras-Mora, José
Oliveras, Teresa
Giralt Borrell, Teresa
Labata, Carlos
Ferrer, Marc
El Ouaddi, Nabil
Montero, Santiago
Elosua Llanos, Roberto
Ribas Barquet, Núria
Bayés-Genís, Antoni
García-García, Cosme
author Martínez Membrive, María José
author_facet Martínez Membrive, María José
Subirana Cachinero, Isaac
Fadeuilhe, Edgar
Rueda, Ferran
Carreras-Mora, José
Oliveras, Teresa
Giralt Borrell, Teresa
Labata, Carlos
Ferrer, Marc
El Ouaddi, Nabil
Montero, Santiago
Elosua Llanos, Roberto
Ribas Barquet, Núria
Bayés-Genís, Antoni
García-García, Cosme
author_role author
author2 Subirana Cachinero, Isaac
Fadeuilhe, Edgar
Rueda, Ferran
Carreras-Mora, José
Oliveras, Teresa
Giralt Borrell, Teresa
Labata, Carlos
Ferrer, Marc
El Ouaddi, Nabil
Montero, Santiago
Elosua Llanos, Roberto
Ribas Barquet, Núria
Bayés-Genís, Antoni
García-García, Cosme
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv STEMI
Atrial fibrillation
Prognosis
Stroke
topic STEMI
Atrial fibrillation
Prognosis
Stroke
description Background: Atrial fibrillation (AF) often complicates ST elevation acute myocardial infarction (STEMI), with associated risks including stroke and mortality. Anticoagulation therapy for these patients and AF prognosis remains controversial. The aim was to evaluate long-term prognosis of STEMI patients complicated with AF in the acute phase. Methods: We performed a retrospective analysis on a prospective register involving 4,184 patients admitted for STEMI to the intensive cardiac care unit of 2 tertiary centres from 2007 to 2015. Patients with pre-existing permanent AF were excluded. Out of these, 269 (6.4%) patients developed AF within the first 48 hours after STEMI and were matched with a control group based on age and left ventricular ejection fraction (LVEF). Results: After matching, a total of 470 patients were included (n=235, AF-STEMI; n=235, control group). Mean age 69.0 years, and 31.7% women. No differences were found in gender, cardiovascular risk factors or ischemic heart disease. AF-STEMI patients experienced more sustained ventricular tachycardia, advanced atrioventricular block, heart failure, and cardiogenic shock. In-hospital mortality was also higher in AF-STEMI patients (11.9% vs 7.2%, p=0.008). After 10-years follow-up, the AF-STEMI group had remained with higher mortality (50.5% vs. 36.2%; p=0.003) and a greater recurrence of AF (44.2% vs. 14.7%; p<0.001), without differences in stroke incidence (10.1% vs. 9.3%). Conclusions: As a conclusion, patients with AF complicating STEMI have higher rates of heart failure, cardiogenic shock, and in-hospital mortality. After a 10-year follow-up, they exhibit a high risk of AF recurrence and mortality, with no significant differences in stroke incidence.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/69353
http://dx.doi.org/10.1093/ehjacc/zuae072
url http://hdl.handle.net/10230/69353
http://dx.doi.org/10.1093/ehjacc/zuae072
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Eur Heart J Acute Cardiovasc Care. 2025 Apr 26;14(4):214-22
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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