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Meta-Analysis
. 2017 Jun 13;7(1):3360.
doi: 10.1038/s41598-017-03653-5.

Atrial fibrillation as a prognostic indicator of myocardial infarction and cardiovascular death: a systematic review and meta-analysis

Wenqi He  1 , Yingjie Chu  2
Affiliations
Meta-Analysis

Atrial fibrillation as a prognostic indicator of myocardial infarction and cardiovascular death: a systematic review and meta-analysis

Wenqi He et al. Sci Rep. .

Abstract

This study aimed to investigate whether atrial fibrillation (AF) predicts myocardial infarction (MI) or cardiovascular (CV) death. AF is a well-established risk factor for thrombotic stroke and all-cause mortality. PubMed, EmBase, and Cochrane Central were searched for articles comparing the incidence rates of MI, CV death, or CV events between AF and non-AF patients. Relative risk ratio (RR) was used as effect estimate. Crude and adjusted RRs were calculated. Data were pooled using a random-effects model. The meta-analysis included 27 studies. In the unadjusted analysis, AF patients had a nonsignificant trend toward a higher risk of MI compared with non-AF patients; however, a significant association was found. The crude data analysis showed that AF was associated with increased risk of CV death (P < 0.05) and CV events (P < 0.05). These associations remained significant after pooling data from adjusted models (CV death: RR = 1.95, 95% CI 1.51-2.51, P < 0.05; CV events: RR = 2.10, 95% CI 1.50-2.95, P < 0.05). These results showed that AF is an independent risk factor for MI, CV death, and CV events.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram showing the study selection process.
Figure 2
Figure 2
Forest plot showing the comparison between AF and non-AF patients in the pooled analysis of crude relative risk for myocardial infarction.
Figure 3
Figure 3
Forest plot showing the comparison between AF and non-AF patients in the pooled analysis of adjusted relative risk for myocardial infarction.
Figure 4
Figure 4
Forest plot showing the comparison between AF and non-AF patients in the pooled analysis of crude relative risk for cardiovascular mortality.
Figure 5
Figure 5
Forest plot showing the comparison between AF and non-AF patients in the pooled analysis of adjusted relative risk for cardiovascular mortality.
Figure 6
Figure 6
Forest plot showing the comparison between AF and non-AF patients in the pooled analysis of crude relative risk for cardiovascular events.
Figure 7
Figure 7
Forest plot showing the comparison between AF and non-AF patients in the pooled analysis of adjusted relative risk for cardiovascular events.
Figure 8
Figure 8
Funnel plot of studies assessing the myocardial infarction outcome.
Figure 9
Figure 9
Funnel plot of studies assessing the CV death outcome.
See this image and copyright information in PMC

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