Asanin Milika, Perunicic Jovan, Mrdovic Igor, Matic Mihailo, Vujisic-Tesic Bosiljka, Arandjelovic Aleksandra, Vojvodic Ana, Marinkovic Jelena, Ostojic Miodrag, Vasiljevic Zorana
University Institute for Cardiovascular Disease, Clinical Center of Serbia, Emergency Center, Belgrade, Serbia&Montenegro.
Int J Cardiol. 2006 May 10;109(2):235-40. doi: 10.1016/j.ijcard.2005.06.009. Epub 2005 Jul 11.
Although new-onset atrial fibrillation (AF) frequently recurs following the acute myocardial infarction, the significance of AF recurrences is unknown.
The objective of the present study was to evaluate the incidence, clinical predictors and prognostic significance of AF recurrences following the acute myocardial infarction.
A total of 320 consecutive patients with AF following the acute myocardial infarction were evaluated and the patients with AF recurrences were compared to those with single episodes of AF in whom AF did not recur after restoration of sinus rhythm. The incidence of AF recurrences was 22.5%. AF recurrences were highly associated with congestive heart failure and worse Killip class was identified as the most important predictor of AF recurrences. Patients with AF recurrences had poorer outcome, including higher in-hospital (36.1% versus 12.9%) and 7-year (68.2% versus 48.6%) mortality. After multivariate adjustment, AF recurrence remained an independent predictor of in-hospital [odds ratio (OR) = 3.08, 95% confidence interval (CI), 1.45-6.53, p = 0.001], and 7-year [relative risk (RR) = 1.52, 95% CI, 1.00-2.31, p = 0.026] mortality.
New-onset AF frequently recurs following the acute myocardial infarction and our analysis demonstrated that recurrences of AF independently predicted in-hospital and long-term mortality.
尽管急性心肌梗死后新发房颤（AF）经常复发，但房颤复发的意义尚不清楚。
本研究的目的是评估急性心肌梗死后房颤复发的发生率、临床预测因素及预后意义。
对320例急性心肌梗死后连续发生房颤的患者进行评估，并将房颤复发患者与窦性心律恢复后未复发房颤的单次发作房颤患者进行比较。房颤复发的发生率为22.5%。房颤复发与充血性心力衰竭高度相关，较差的Killip分级被确定为房颤复发的最重要预测因素。房颤复发患者的预后较差，包括较高的住院死亡率（36.1%对12.9%）和7年死亡率（68.2%对48.6%）。多因素调整后，房颤复发仍然是住院死亡率[比值比（OR）=3.08，95%置信区间（CI），1.45 - 6.53，p = 0.001]和7年死亡率[相对风险（RR）=1.52，95%CI，1.00 - 2.31，p = 0.026]的独立预测因素。
急性心肌梗死后新发房颤经常复发，我们的分析表明房颤复发独立预测住院和长期死亡率。
