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. 2017 Oct 5;7(1):12716.
doi: 10.1038/s41598-017-13061-4.

Atrial fibrillation and the risk of myocardial infarction: a nation-wide propensity-matched study

Hye Young Lee  1   2 , Pil-Sung Yang  1 , Tae-Hoon Kim  1 , Jae-Sun Uhm  1 , Hui-Nam Pak  1 , Moon-Hyoung Lee  1 , Boyoung Joung  3
Affiliations

Atrial fibrillation and the risk of myocardial infarction: a nation-wide propensity-matched study

Hye Young Lee et al. Sci Rep. .

Abstract

In addition to being an established complicating factor for myocardial infarction (MI), recent studies have revealed that atrial fibrillation (AF) increased risk of MI. This study is to evaluate the risk of MI associated with AF in a nationwide population based cohort. We examine the association between AF and incident MI in 497,366 adults from the Korean National Health Insurance Service database, who were free of AF and MI at baseline. AF group (n = 3,295) was compared with propensity matched no-AF group (n = 13,159). Over 4.2 years of follow up, 137 MI events occurred. AF was associated with 3-fold increased risk of MI (HR, 3.1; 95% CI, 2.22-4.37) in both men (HR, 2.91; 95% CI 1.91-4.45) and women (HR, 3.52; 95% CI 2.01-6.17). The risk of AF-associated MI was higher in patients free of hypertension, diabetes, ischemic stroke, and dyslipidemia at baseline. The cumulative incidence of AF-associated MI was lower in patients on anticoagulant and statin therapies. Our finding suggests that AF complications beyond stoke should extend to total mortality to include MI.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Study population. NHIS HCK, National Health Insurance Service-health check-up; AF, atrial fibrillation; MI, myocardial infarction.
Figure 2
Figure 2
Unadjusted cumulative incidence of myocardial infarction by baseline atrial fibrillation status in the entire cohort (a) and in the propensity scored matched cohort (b). Cumulative incidence was calculated using Kaplan-Meier estimates and compared using the log-rank test.
Figure 3
Figure 3
Age-adjusted incidence rate and incidence rate ratios of myocardial infarction by atrial fibrillation status. Incidence rate per 1,000 person-years. *Age adjusted incidence rate and incidence rate ratios were based on the average of the cohort.
Figure 4
Figure 4
Effects of atrial fibrillation on the risk of myocardial infarction in different groups of patients. CI, confidence interval. Hazard ratios were calculated based on Cox regression after propensity matching. The P for interaction was calculated using the interaction term for AF and each subgroup based on Cox regression.
Figure 5
Figure 5
Risk of incident myocardial infarction associated with medication in patients with atrial fibrillation. The cumulative incidences of myocardial infarction were calculated using Kaplan-Meier estimates and compared using the log-rank test.
See this image and copyright information in PMC

References

    1. Miyasaka Y, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:119–125. doi: 10.1161/CIRCULATIONAHA.105.595140. - DOI - PubMed
    1. Go AS, et al. 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;285:2370–2375. doi: 10.1001/jama.285.18.2370. - DOI - PubMed
    1. Conen D, et al. Risk of death and cardiovascular events in initially healthy women with new-onset atrial fibrillation. JAMA. 2011;305:2080–2087. doi: 10.1001/jama.2011.659. - DOI - PMC - PubMed
    1. Miyasaka Y, et al. Mortality trends in patients diagnosed with first atrial fibrillation: a 21-year community-based study. J Am Coll Cardiol. 2007;49:986–992. doi: 10.1016/j.jacc.2006.10.062. - DOI - PubMed
    1. Hod H, et al. Early atrial fibrillation during evolving myocardial infarction: a consequence of impaired left atrial perfusion. Circulation. 1987;75:146–150. doi: 10.1161/01.CIR.75.1.146. - DOI - PubMed

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