The impact of atrial fibrillation type on clinical outcomes and antithrombotic therapy at discharge in patients with acute coronary syndrome or undergoing percutaneous coronary intervention: a real-world study.

BACKGROUND

The type of atrial fibrillation (AF) is assumed as a vital factor in AF patients' prognosis. However, its impact on clinical outcomes remains unclear in patients with AF complicated with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI).

METHODS

This study was a prospective, observational, single center study of adults with AF and ACS/PCI. The primary endpoint was major adverse cardiovascular events (MACE), and secondary endpoint was net adverse clinical outcome events (NACE), a composite of MACE events and major bleeding events.

RESULTS

A total of 1,762 participants were enrolled in this study, 1,137 of them were paroxysmal AF and 625 were non- paroxysmal AF, with a median follow up time of 1,023 days. The mean age of this population was 67 ± 10 and 27.2% were female. Kaplan-Meier curves showed patients were under a higher incidence of both MACE (p < 0.001) and NACE (p < 0.001) in patients with non-paroxysmal AF. Multivariate Cox analysis showed that patients with non-paroxysmal AF had a higher risk of MACE (HR: 1.322; 95%CI 1.074-1.626) and NACE (HR: 1.341; 95%CI 1.095-1.644) compared to those with paroxysmal AF.

CONCLUSIONS

Our study demonstrated that among patients with ACS/PCI, those with non-paroxysmal AF were more likely to experience MACE and NACE.