In Hospital Atrial Fibrillation is a Predictor of Long Term Stroke Event among Patients with Acute Myocardial Infarction

  • Manoefris Kasim Department of Cardiology and Vascular Medicine, Faculty of Medi-cine, University of Indonesia, and National Cardiovascular Center Harapan Kita, Jakarta
  • Octavia Lilyasari Department of Cardiology and Vascular Medicine, Faculty of Medi-cine, University of Indonesia, and National Cardiovascular Center Harapan Kita, Jakarta
  • Yoga Yuniadi Department of Cardiology and Vascular Medicine, Faculty of Medi-cine, University of Indonesia, and National Cardiovascular Center Harapan Kita, Jakarta

Abstract

Background. Atrial fibrillation (AF) is a common arrhythmia after acute myocardial infarction (AMI).Mortality in AMI patients with AF also been shown to be up to twice as high as for those without AF. Non hemorrhagic stroke occurs in 0.1% to 1.3%of patients with acute myocardial infarction who are treatedwith thrombolytic, with substantial associated mortality and morbidity. The aim of this study is toelaborate correlation between in hospital AF with long term stroke event inST-elevation myocardial infarction (STEMI) patients who treated with thrombolytic.
Methods. Two hundred and thirty STEMI patients (27-72 yo) treated with thrombolytic agent were studied retrospectively. The study end point was Major Cardio-Cerebrovascular Event (MACCE) during 3 years follow up.
Results. Eleven patients experience AF episode during STEMI hospitalization. During 3 years follow up 24 patients (10.4%) experienced MACCE which comprised of : cardiac death 4 (1.7%), fatal infarction 2 (0.9%), non fatal infarction 13 (5.7%) and stroke 5 (2.2%). Independent clinical variables were not significant as a predictor for the occurrence of future stroke event, except atrial fibrillation episode (HR 13.4; p<0.005) that was encountered during hospitalization in the setting of AMI.
Conclusion. In-hospital AF in STEMI patients treated with thrombolytic agent is a predictor of long term stroke.

Downloads

Download data is not yet available.

References

Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA.2001;285(18):2370­2375.

Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart.2001;86(5):516­521.

Gore JM, Granger CB, Simoons ML, Sloan MA, Weaver WD, White HD, Barbash GI, Van de Werf F, Aylward PE, Topol EJ, et al. Stroke after thrombolysis. Mortality and functional outcomes in the GUSTO­I trial. Global Use of Strategies to Open Occluded Coronary Arteries. Circulation.1995;92(10):2811­2818.

Longstreth WT, Jr., Litwin PE, Weaver WD. Myocardial infarction, thrombolytic therapy, and stroke.A community­based study.The MITI Project Group.Stroke.1993;24(4):587­590.

Maggioni AP, Franzosi MG, Santoro E, White H, Van de Werf F, Tognoni G. The risk of stroke in patients with acute myocardial infarction after thrombolytic and antithrombotic treatment. GruppoItaliano per lo Studio della Sopravvivenzanell’Infarto Miocardico II (GISSI­2), and The International Study Group. N Engl J Med. 1992;327(1):1­6.

O’Connor CM, Califf RM, Massey EW, Mark DB, Kereiakes DJ, Candela RJ, Abbottsmith C, George B, Stack RS, Aronson L, et al. Stroke and acute myocardial infarction in the thrombolytic era: clinical correlates and long­term prognosis. J Am CollCardiol. 1990;16(3):533­540.

Mooe T, Eriksson P, Stegmayr B. Ischemic stroke after acute myocardial infarction. A population­based study. Stroke. 1997;28(4):762­767.

Lichtman JH, Krumholz HM, Wang Y, Radford MJ, Brass LM. Risk and predictors of stroke after myocardial infarction among the elderly: results from the Cooperative Cardiovascular Project. Circulation.2002;105(9):1082­1087.

Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, Solomon AJ. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. 2000;101(9):969­974.

Crenshaw BS, Ward SR, Granger CB, Stebbins AL, Topol EJ, Califf RM. Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO­I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. J Am CollCardiol. 1997;30(2):406­413.
Views & Downloads
Abstract views: 2786   
PDF downloads: 1885   
How to Cite
Kasim, M., Lilyasari, O., & Yuniadi, Y. (1). In Hospital Atrial Fibrillation is a Predictor of Long Term Stroke Event among Patients with Acute Myocardial Infarction. Indonesian Journal of Cardiology, 32(4), 223-8. https://doi.org/10.30701/ijc.v32i4.82
Section
Clinical Research

Most read articles by the same author(s)