Rhyou Hyo-In, Park Tae-Ho, Cho Young-Rak, Park Kyungil, Park Jong-Sung, Kim Moo-Hyun, Kim Young-Dae
Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea.
Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea.
J Cardiol. 2018 Feb;71(2):125-128. doi: 10.1016/j.jjcc.2017.08.004. Epub 2017 Sep 29.
Advanced age, poor left ventricular function, and congestive heart failure are known predictors of atrial fibrillation (AF) in acute myocardial infarction (AMI) patients. Recent advances in AMI treatment may have changed the occurrence of new-onset AF. Thus, we investigated the factors associated with the development of new-onset AF in ST elevation myocardial infarction (STEMI) patients.
This study included 527 STEMI patients [mean age, 60.6±12.8 years; 102 (19.4%) women] who underwent primary percutaneous coronary intervention (PCI) in the previous 7 years. New-onset AF was evaluated following STEMI treated by primary PCI. Patients who developed AF during this follow-up period were compared with those who did not develop AF to identify factors that were associated with the development of AF.
New-onset AF was documented in 81 patients (15.4%) at 1 year after STEMI. Patients with new-onset AF (n=81) tended to be older (p<0.001); were more often female (p=0.009); had more congestive heart failure (p=0.015); had less use of beta-blockers (p=0.001); had more often used antiarrhythmic drugs (p<0.001); experienced cardiogenic shock more frequently (p=0.038); had lower left ventricular ejection fraction (p=0.024); and had higher E velocity (p<0.001), E/e' (p=0.011), and left atrial volume index (LAVI; p=0.029) than the 446 patients with no AF. Multivariate regression analysis revealed that cardiogenic shock, LAVI, and age were predictors of new-onset AF in STEMI patients (OR 2.823, 1.254, and 1.124; p=0.005, <0.001, and 0.028, respectively).
Cardiogenic shock was a new predictor of new-onset AF in STEMI patients.
高龄、左心室功能差和充血性心力衰竭是急性心肌梗死（AMI）患者发生心房颤动（AF）的已知预测因素。AMI治疗的最新进展可能改变了新发AF的发生率。因此，我们研究了ST段抬高型心肌梗死（STEMI）患者新发AF发生的相关因素。
本研究纳入了527例在过去7年中接受直接经皮冠状动脉介入治疗（PCI）的STEMI患者[平均年龄，60.6±12.8岁；102例（19.4%）为女性]。在直接PCI治疗的STEMI后评估新发AF。将在此随访期间发生AF的患者与未发生AF的患者进行比较，以确定与AF发生相关的因素。
81例患者（15.4%）在STEMI后1年记录到新发AF。新发AF患者（n = 81）往往年龄更大（p<0.001）；女性更多（p = 0.009）；充血性心力衰竭更多（p = 0.015）；β受体阻滞剂使用较少（p = 0.001）；抗心律失常药物使用更频繁（p<0.001）；心源性休克更频繁（p = 0.038）；左心室射血分数更低（p = 0.024）；E速度（p<0.001）、E/e'（p = 0.011）和左心房容积指数（LAVI；p = 0.029）高于446例未发生AF的患者。多因素回归分析显示，心源性休克、LAVI和年龄是STEMI患者新发AF的预测因素（OR分别为2.823、1.254和1.124；p分别为0.005、<0.001和0.028）。
心源性休克是STEMI患者新发AF的一个新的预测因素。
