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    Comparison of outcomes of patients with acute coronary syndromes with and without atrial fibrillation

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    Authors
    Mehta, Rajendra H.
    Dabbous, Omar H.
    Granger, Christopher B.
    Kuznetsova, Polina
    Kline-Rogers, Eva M.
    Anderson, Frederick A.
    Fox, Keith A. A.
    Gore, Joel M.
    Goldberg, Robert J.
    Eagle, Kim A.
    UMass Chan Affiliations
    Department of Surgery
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2003-10-30
    Keywords
    Acute Disease
    Aged
    Aged, 80 and over
    Angina, Unstable
    Atrial Fibrillation
    Female
    Humans
    Male
    Middle Aged
    Myocardial Infarction
    Syndrome
    Treatment Outcome
    Bioinformatics
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1016/j.amjcard.2003.06.001
    Abstract
    Preexisting or new-onset atrial fibrillation (AF) commonly occurs in patients with an acute coronary syndrome (ACS). However, it is currently unknown if previous or new-onset AF confers different risks in these patients. To determine the prognostic significance of new-onset and previous AF in patients with ACS, we evaluated all patients with ACS enrolled in the multinational Global Registry of Acute Coronary Events (GRACE) between April 1999 and September 2001. We compared clinical characteristics, management, and hospital outcomes in patients with ACS and new-onset and previous AF with those without AF. Of a total of 21,785 patients with ACS enrolled in GRACE, 1,700 (7.9%) had previous AF and 1,221 (6.2%) had new-onset AF. Patients with any AF were older, more likely to be women, had more co-morbid conditions, and worse hemodynamic status. Most in-hospital adverse events (reinfarction, shock, pulmonary edema, bleeding, stroke, and mortality) were significantly higher in patients with any AF than those without AF. Only new-onset AF (not previous AF) was an independent predictor of all adverse in-hospital outcomes. We conclude that compared with patients with ACS without any AF, previous and new-onset AF are associated with increased hospital morbidity and mortality. However, only new-onset AF is an independent predictor of in-hospital adverse events in patients with ACS.
    Source
    Am J Cardiol. 2003 Nov 1;92(9):1031-6.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47163
    PubMed ID
    14583352
    Related Resources
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    Population and Quantitative Health Sciences Publications

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