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New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome

The indications for the treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are clear, while less is available about the management of new-onset AF (NOAF) during ST-segment elevation myocardial infarction (STEMI). The aim of this study is to...

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Autores principales: Dal Zotto, Beatrice, Barbieri, Lucia, Tumminello, Gabriele, Saviano, Massimo, Gentile, Domitilla, Lucreziotti, Stefano, Frattini, Loredana, Tarricone, Diego, Carugo, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955053/
https://www.ncbi.nlm.nih.gov/pubmed/36832101
http://dx.doi.org/10.3390/diagnostics13040613
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author Dal Zotto, Beatrice
Barbieri, Lucia
Tumminello, Gabriele
Saviano, Massimo
Gentile, Domitilla
Lucreziotti, Stefano
Frattini, Loredana
Tarricone, Diego
Carugo, Stefano
author_facet Dal Zotto, Beatrice
Barbieri, Lucia
Tumminello, Gabriele
Saviano, Massimo
Gentile, Domitilla
Lucreziotti, Stefano
Frattini, Loredana
Tarricone, Diego
Carugo, Stefano
author_sort Dal Zotto, Beatrice
collection PubMed
description The indications for the treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are clear, while less is available about the management of new-onset AF (NOAF) during ST-segment elevation myocardial infarction (STEMI). The aim of this study is to evaluate mortality and clinical outcome of this high-risk subgroup of patients. We analyzed 1455 consecutive patients undergoing PCI for STEMI. NOAF was detected in 102 subjects, 62.7% males, with a mean age of 74.8 ± 10.6 years. The mean ejection fraction (EF) was 43.5 ± 12.1% and the mean atrial volume was increased (58 ± 20.9 mL). NOAF occurred mainly in the peri-acute phase and had a very variable duration (8.1 ± 12.5 min). During hospitalization, all the patients were treated with enoxaparin, but only 21.6% of them were discharged with long term oral anticoagulation. The majority of patients had a CHA2DS2-VASc score >2 and a HAS-BLED score of 2 or 3. The in-hospital mortality was 14.2%, while the 1-year mortality was 17.2% and long-term mortality 32.1% (median follow-up 1820 days). We identified age as an independent predictor of mortality both at short- and long-term follow-ups, while EF was the only independent predictor for in-hospital mortality and arrhythmia duration for 1-year mortality. At the 1-year follow-up, we recorded three ischemic strokes and no bleeding complications.
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spelling pubmed-99550532023-02-25 New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome Dal Zotto, Beatrice Barbieri, Lucia Tumminello, Gabriele Saviano, Massimo Gentile, Domitilla Lucreziotti, Stefano Frattini, Loredana Tarricone, Diego Carugo, Stefano Diagnostics (Basel) Article The indications for the treatment of patients with known atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are clear, while less is available about the management of new-onset AF (NOAF) during ST-segment elevation myocardial infarction (STEMI). The aim of this study is to evaluate mortality and clinical outcome of this high-risk subgroup of patients. We analyzed 1455 consecutive patients undergoing PCI for STEMI. NOAF was detected in 102 subjects, 62.7% males, with a mean age of 74.8 ± 10.6 years. The mean ejection fraction (EF) was 43.5 ± 12.1% and the mean atrial volume was increased (58 ± 20.9 mL). NOAF occurred mainly in the peri-acute phase and had a very variable duration (8.1 ± 12.5 min). During hospitalization, all the patients were treated with enoxaparin, but only 21.6% of them were discharged with long term oral anticoagulation. The majority of patients had a CHA2DS2-VASc score >2 and a HAS-BLED score of 2 or 3. The in-hospital mortality was 14.2%, while the 1-year mortality was 17.2% and long-term mortality 32.1% (median follow-up 1820 days). We identified age as an independent predictor of mortality both at short- and long-term follow-ups, while EF was the only independent predictor for in-hospital mortality and arrhythmia duration for 1-year mortality. At the 1-year follow-up, we recorded three ischemic strokes and no bleeding complications. MDPI 2023-02-07 /pmc/articles/PMC9955053/ /pubmed/36832101 http://dx.doi.org/10.3390/diagnostics13040613 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dal Zotto, Beatrice
Barbieri, Lucia
Tumminello, Gabriele
Saviano, Massimo
Gentile, Domitilla
Lucreziotti, Stefano
Frattini, Loredana
Tarricone, Diego
Carugo, Stefano
New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome
title New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome
title_full New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome
title_fullStr New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome
title_full_unstemmed New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome
title_short New Onset Atrial Fibrillation in STEMI Patients: Main Prognostic Factors and Clinical Outcome
title_sort new onset atrial fibrillation in stemi patients: main prognostic factors and clinical outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955053/
https://www.ncbi.nlm.nih.gov/pubmed/36832101
http://dx.doi.org/10.3390/diagnostics13040613
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