Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction
Background New‐onset atrial fibrillation (NOAF) is a common complication after acute myocardial infarction (AMI) and is associated with poor survival. Atrial fibrillation (AF) burden is used to characterize the severity of AF. However, the association of AF burden with cardiovascular outcomes in NOA...
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| Format: | Article |
| Language: | English |
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Wiley
2025-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.039547 |
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| author | Jiachen Luo Xiaoming Qin Yiqian Yuan Yiwei Zhang Jieyun Liu Yaoxin Wang Guojun Zhao Lili Xiao Xingxu Zhang Yuan Fang Wentao Shi Lei Qin Baoxin Liu Yidong Wei |
| author_facet | Jiachen Luo Xiaoming Qin Yiqian Yuan Yiwei Zhang Jieyun Liu Yaoxin Wang Guojun Zhao Lili Xiao Xingxu Zhang Yuan Fang Wentao Shi Lei Qin Baoxin Liu Yidong Wei |
| author_sort | Jiachen Luo |
| collection | DOAJ |
| description | Background New‐onset atrial fibrillation (NOAF) is a common complication after acute myocardial infarction (AMI) and is associated with poor survival. Atrial fibrillation (AF) burden is used to characterize the severity of AF. However, the association of AF burden with cardiovascular outcomes in NOAF complicating AMI is poorly understood. We aimed to investigate the prognostic impact of AF burden in NOAF complicating AMI. Methods and Results This multicenter retrospective cohort study included patients with AMI without a medical history of AF who developed the first documented AF during hospitalization between January 2014 and January 2022. AF burden was defined as the percentage of time spent in AF during hospitalization. The primary outcome was a composite of cardiovascular death, heart failure hospitalization, reinfarction, or ischemic stroke. A total of 812 patients with AMI and NOAF (mean age, 72.7±10.9 years; 552 men) were included. An AF burden of 15.29% was identified as the cutoff value for prognostic stratification; 663 patients with complete follow‐up data were then classified into the low‐burden (AF burden <15.29%; n=447) and high‐burden (AF burden ≥15.29%; n=216) groups. During a median of 4.2 years of follow‐up, high AF burden was associated with an increased risk of the composite outcomes (hazard ratio [HR], 1.66 [95% CI, 1.30–2.12]; P<0.001) after multivariable adjustment. When measured as a continuous scale, increasing AF burden remained an independent predictor of the composite outcomes (HR, 1.06 per 10% AF burden [95% CI, 1.02–1.09]; P=0.004). Conclusions A greater burden of AF is associated with a higher risk of cardiovascular outcomes among patients with NOAF complicating AMI. |
| format | Article |
| id | doaj-art-09afbe960e2a407788db36aa27223fbd |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-09afbe960e2a407788db36aa27223fbd2025-08-20T02:32:42ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-05-01141010.1161/JAHA.124.039547Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial InfarctionJiachen Luo0Xiaoming Qin1Yiqian Yuan2Yiwei Zhang3Jieyun Liu4Yaoxin Wang5Guojun Zhao6Lili Xiao7Xingxu Zhang8Yuan Fang9Wentao Shi10Lei Qin11Baoxin Liu12Yidong Wei13Department of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology Kaifeng Central Hospital Kaifeng Henan ChinaDepartment of Cardiology Kaifeng Central Hospital Kaifeng Henan ChinaDepartment of Cardiology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan ChinaDepartment of Cardiology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology Kaifeng Central Hospital Kaifeng Henan ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaDepartment of Cardiology, Shanghai Tenth People’s Hospital Tongji University School of Medicine Shanghai ChinaBackground New‐onset atrial fibrillation (NOAF) is a common complication after acute myocardial infarction (AMI) and is associated with poor survival. Atrial fibrillation (AF) burden is used to characterize the severity of AF. However, the association of AF burden with cardiovascular outcomes in NOAF complicating AMI is poorly understood. We aimed to investigate the prognostic impact of AF burden in NOAF complicating AMI. Methods and Results This multicenter retrospective cohort study included patients with AMI without a medical history of AF who developed the first documented AF during hospitalization between January 2014 and January 2022. AF burden was defined as the percentage of time spent in AF during hospitalization. The primary outcome was a composite of cardiovascular death, heart failure hospitalization, reinfarction, or ischemic stroke. A total of 812 patients with AMI and NOAF (mean age, 72.7±10.9 years; 552 men) were included. An AF burden of 15.29% was identified as the cutoff value for prognostic stratification; 663 patients with complete follow‐up data were then classified into the low‐burden (AF burden <15.29%; n=447) and high‐burden (AF burden ≥15.29%; n=216) groups. During a median of 4.2 years of follow‐up, high AF burden was associated with an increased risk of the composite outcomes (hazard ratio [HR], 1.66 [95% CI, 1.30–2.12]; P<0.001) after multivariable adjustment. When measured as a continuous scale, increasing AF burden remained an independent predictor of the composite outcomes (HR, 1.06 per 10% AF burden [95% CI, 1.02–1.09]; P=0.004). Conclusions A greater burden of AF is associated with a higher risk of cardiovascular outcomes among patients with NOAF complicating AMI.https://www.ahajournals.org/doi/10.1161/JAHA.124.039547atrial fibrillation burdenmulticentermyocardial infarctioncardiovascular outcomesretrospective cohort study |
| spellingShingle | Jiachen Luo Xiaoming Qin Yiqian Yuan Yiwei Zhang Jieyun Liu Yaoxin Wang Guojun Zhao Lili Xiao Xingxu Zhang Yuan Fang Wentao Shi Lei Qin Baoxin Liu Yidong Wei Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation burden multicenter myocardial infarction cardiovascular outcomes retrospective cohort study |
| title | Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction |
| title_full | Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction |
| title_fullStr | Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction |
| title_full_unstemmed | Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction |
| title_short | Association of Atrial Fibrillation Burden With Cardiovascular Outcomes in New‐Onset Atrial Fibrillation Complicating Myocardial Infarction |
| title_sort | association of atrial fibrillation burden with cardiovascular outcomes in new onset atrial fibrillation complicating myocardial infarction |
| topic | atrial fibrillation burden multicenter myocardial infarction cardiovascular outcomes retrospective cohort study |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.039547 |
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