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This Article Full Text (PDF) Free All Versions of this Article: chest.06-2733v1 132/1/44    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Siu, C.-W. Articles by Tse, H.-F. Search for Related Content PubMed PubMed Citation Articles by Siu, C.-W. Articles by Tse, H.-F. Related Content Related Editorial

Transient Atrial Fibrillation Complicating Acute Inferior Myocardial Infarction: Implications for Future Risk of Ischemic Stroke

¹Cardiology Division, Department of Medicine, Queen Mary Hospital, and ²Research Centre of Heart, Brain, Hormone & Healthy Aging, the University of Hong Kong, Hong Kong. China

hftse{at}hkucc.hku.hk

Abstract

BackgroundAtrial fibrillation AF that occurs as a frequent complication of myocardial infarction MI is associated with a poor clinical outcome. It nonetheless remains uncertain whether AF that occurs transiently during MI is associated with a subsequent increased risk of development of AF and ischemic stroke.

MethodsWe retrospectively studied the impact of transient AF on the long-term risk of AF occurrence, ischemic stroke, and mortality in 431 consecutive patients 64± 1years old, 75% male. All had experienced an acute inferior ST-segment elevation MI and had preserved left ventricular ejection fraction LVEF >45%.

ResultsAll patients were in sinus rhythm on admission, and transient AF was observed in 59 patients 13.7% during hospitalization for MI. On discharge, all patients were in sinus rhythm and prescribed anti-platelet agents alone as anti-thrombotic therapy. Patients who developed transient AF during MI were older 70± 1.4 vs. 64± 0.7 years, P<0.01 and more likely female 37 vs. 23%, P<0.02 compared with those without AF. At one-year follow-up, the incidence of AF and ischemic stroke was higher in patients with transient AF than those without 22.0 vs. 1.3%, P<0.01; 10.2 vs. 1.8%, P<0.01, respectively. Total mortality was nonetheless similar 5.6% vs. 6.8%, P=0.73, Cox regression analysis demonstrated that age >65years and transient AF during MI were independent predictors of subsequent AF occurrence and development of ischemic stroke.

ConclusionTransient AF complicating acute inferior MI is associated with an increased future risk of AF occurrence and ischemic stroke in patients with preserved LVEF, despite the use of anti-platelet therapy.

Key Words: atrial fibrillation • myocardial infarction • stroke

Related Editorial

Coronary Artery Disease and Ischemic Stroke in Atrial Fibrillation

Gregory Y. H. Lip
Chest 2007 132: 8-10. [Full Text] [PDF]

This article has been cited by other articles:

				G. Y. H. Lip Coronary Artery Disease and Ischemic Stroke in Atrial Fibrillation Chest, July 1, 2007; 132(1): 8 - 10. [Full Text] [PDF]