Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;40(5):275-280.
doi: 10.1002/clc.22654. Epub 2016 Dec 5.

Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real-world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000-2013

Aharon Erez  1 , Ilan Goldenberg  1 , Avi Sabbag  1 , Eyal Nof  1 , Doron Zahger  2 , Shaul Atar  3 , Arthur Pollak  4 , Idit Dobrecky-Merye  5 , Roy Beigel  1 , Shlomi Matetzky  1 , Michael Glikson  1 , Roy Beinart  1
Affiliations

Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real-world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000-2013

Aharon Erez et al. Clin Cardiol. 2017 May.

Abstract

Background: The past decade has brought major advances in therapy of patients presenting with acute coronary syndromes (ACS).

Hypothesis: The outcomes of ACS patients with atrial fibrillation (AF) has improved over the years.

Methods: We evaluated time-dependent changes in clinical characteristics, management strategies, and outcomes associated with AF observed during ACS hospitalization in patients enrolled in the biannual ACS Israeli Surveys (ACSIS) between 2000 and 2013. We divided the surveys into early (2000-2006) and late (2008-2013) time periods.

Results: The study population comprised 13 297 ACS patients, of whom 755 (5.7%) either presented with or developed AF during the index hospitalization. The incidence of AF observed during ACS hospitalization was lower during the later period (6.2% vs 4.9%; P < 0.01). Kaplan-Meier survival analysis showed that 1-year mortality rates were significantly lower among ACS patients with and without AF who were enrolled during the later vs early survey period (log-rank P < 0.01 for the overall difference). However, AF observed among ACS patients was still associated with increased risk for in-hospital complications and 30-day and 1-year mortality during both the early and late survey periods (P < 0.05 for all comparisons).

Conclusions: In 10 years, rates of AF among ACS patients have declined significantly. Yet, despite improved overall 1-year survival for patients with AF, the development of AF in this population remains an independent predictor of mortality that has not changed appreciably over the years.

Keywords: ACSIS registry; Acute coronary syndrome; atrial fibrillation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Figure 1
Figure 1
Incidence of AF observed during ACS hospitalization according to survey year. P for trend < 0.001. Abbreviations: ACS, acute coronary syndrome; AF, atrial fibrillation.
Figure 2
Figure 2
One‐year all‐cause mortality in patients with and without AF according to survey periods. Abbreviations: AF, atrial fibrillation; KM, Kaplan‐Meier.
Figure 3
Figure 3
Trends in the 1‐year all‐cause mortality outcome according to survey year and the presence of AF during the ACS hospitalization. Abbreviations: ACS, acute coronary syndrome; AF, atrial fibrillation.
See this image and copyright information in PMC

References

    1. Schmitt J, Duray G, Gersh BJ, et al. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. Eur Heart J. 2009;30:1038–1045. - PubMed
    1. Yeh RW, Sidney S, Chandra M, et al. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010;362:2155–2165. - PubMed
    1. Orvin K, Eisen A, Goldenberg I, et al. Outcome of contemporary acute coronary syndrome complicated by ventricular tachyarrhythmias. Europace. 2016;18:219–226. - PubMed
    1. Eagle KA, Lim MJ, Dabbous OH, et al; GRACE Investigators . A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6‐month postdischarge death in an international registry. JAMA . 2004;291:2727–2733. - PubMed
    1. Huang SS, Chan WL, Leu HB, et al. Association between CHADS2 score and the preventive effect of statin therapy on new‐onset atrial fibrillation in patients with acute myocardial infarction. PloS One. 2013;8:e74709. - PMC - PubMed

MeSH terms

LinkOut - more resources