Atrial fibriallation and mortality risk following myocardial infarction

January 01, 0001

Atrial fibriallation and mortality risk following myocardial infarction

Atrial fibrillation (AF) is a common occurrence with myocardial infarction (MI). However, it’s prognostic implication is unclear. These French researchers performed a systematic review and meta-analysis to characterize the mortality risk associated with AF in MI patients. A random- effects model was used to calculate odds ratios.

The researchers found: "In the 43 included studies (278 854 subjects), the mortality odds ratio associated with AF was 1.46. This worse prognosis persisted regardless of the timing of AF. The odds ratio of mortality for new AF with no prior history of AF was 1.37, and for prior AF was 1.28. The sensitivity analysis of new AF studies adjusting for confounding factors did not show a decrease in risk of death."

The researchers concluded: "Atrial fibrillation is associated with increased risk of mortality in MI patients. New AF with no history of AF before MI remained associated with an increased risk of mortality even after adjustment for several important AF risk factors. These subsequent increases in mortality suggest that AF can no longer be considered a nonsevere event during MI."

This systematic review suggests atrial fibrillation is associated with an increased mortality risk and may be a poor prognostic indicator

For the full abstract, click here.

Circulation 123(15):1587-1593, 19 April 2011
© 2011 American Heart Association, Inc.
Mortality Associated With Atrial Fibrillation in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis. Patricia Jabre, Véronique L. Roger, Mohammad H. Murad, et al. Correspondence to Patricia Jabre:

Category: K. Circulatory. Keywords: atrial fibrillation, myocardial infarction, onset, timing, mortality, systematic review with meta-analyis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 10 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.