Coronary Embolism Among Patients With ST-Segment-Elevation Myocardial Infarction and Atrial Fibrillation: An Underrecognized But Deadly Association.
J Am Heart Assoc
; 13(10): e032199, 2024 May 21.
Article
em En
| MEDLINE
| ID: mdl-38742522
ABSTRACT
BACKGROUND:
The prevalence and impact of coronary emboli (CE) in patients with ST-segment-elevation myocardial infarction (STEMI) and atrial fibrillation (AF) have not been specifically studied. The objective was to describe the clinical characteristics and outcomes of patients with AF and CE in a large series of patients with STEMI. METHODS ANDRESULTS:
We investigated 2292 consecutive patients with STEMI and among them 225 patients with AF 46 patients with a STEMI related to CE (group A) and 179 patients with a STEMI related to an atherosclerotic cause (group B). Compared with the 2067 patients without AF and CE (group C), patients with AF and CE were older (73 versus 59 years, P<0.05), more likely to be female (43% versus 22%, P<0.05), and presented more frequently with cardiogenic shock at admission (26% versus 9%, P<0.05). The baseline characteristics of patients with AF (group A versus B) did not differ significantly according to STEMI pathogenesis. In the unadjusted analysis, the 45-day mortality was higher in patients with CE and AF (group A versus group C 20% versus 4%; P<0.05 and group A versus group B 20% versus 8%, P=not significant); this trend persisted at 2-year follow-up (group A versus group C 24% versus 6%; P<0.05 and group A versus group B 24% versus 17%, P=not significant). After stabilized inverse exposure probability weighting adjustment, a higher 45-day mortality rate was confirmed in patients with CE and AF (group A versus group C 18% versus 5%, P<0.05).CONCLUSIONS:
In patients presenting with STEMI and AF, CE was associated with excess early mortality. REGISTRATION URL clinicaltrials.gov. Identifier NCT05679843.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Embolia
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Infarto do Miocárdio com Supradesnível do Segmento ST
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Am Heart Assoc
Ano de publicação:
2024
Tipo de documento:
Article