Fast Five Quiz: Atrial Fibrillation and Acute Coronary Syndrome

Sandeep K. Goyal, MD


March 10, 2022

Figure 2. Atrial fibrillation is a common type of arrhythmia resulting in rapid and irregular heart and pulse rates. The illustration depicts the electrical nerve impulses causing rapid and chaotic beating of the heart when the atria fibrillate. Fibrillation may affect the atrial chambers or the ventricles independently.

In a large (N= 659,52) study of hospitalized patients undergoing percutaneous coronary intervention, both prevalent AF and incident AF were associated with complications and worse outcomes. Incident AF was associated with a higher in-hospital mortality rate, longer length of stay, higher direct costs, and higher rate of complications, including stroke and acute kidney injury, compared with prevalent AF.

Similarly, in a recent prospective cohort study (N= 10,137), the incidence of ischemic stroke after acute MI was significantly higher in patients with previous AF than in those with new-onset AF or without AF. The incidence rate was not significantly different between men with new-onset AF and without AF, but women with new-onset AF showed an intermediate incidence rate for ischemic stroke between patients with previous AF and those without AF. Both new-onset AF and previous AF were associated with increased risk for ischemic stroke; however, new-onset AF was a strong independent risk factor of ischemic stroke in women but not in men, and its predictive value for ischemic stroke was comparable to that of previous AF.

Several studies have shown that there is a statistically significant increased risk for MI among Black people with AF than there is among White people with AF.

Learn more about risk factors for ACS.


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