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Mortality Associated With Atrial Fibrillation in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis
Open accessAbstract
Background—: Atrial fibrillation (AF) is a common finding in patients with myocardial infarction (MI). Atrial fibrillation is not generally perceived by clinicians as a critical event during the acute phase of MI; however, its prognostic influence in MI remains controversial. Furthermore, contradictory data exist concerning the risk of death according to AF timing. This article, a systematic review and first meta-analysis, aims to quantify the mortality risk associated with AF in MI patients and its timing. Methods and Results—: A comprehensive search of several electronic databases (1970 to 2010; adults, any language) identified MI studies that evaluated mortality related to AF. Evidence was reviewed by 2 blinded reviewers with a formal assessment of the methodological quality of the studies. Adjusted odds ratios were pooled across studies using the random-effects model. The I 2 statistic was used to assess heterogeneity. In the 43 included studies (278 854 subjects), the mortality odds ratio associated with AF was 1.46 (95% confidence interval, 1.35 to 1.58; I 2 =76%; 23 studies). 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 (95% confidence interval, 1.26 to 1.49), I 2 =28%, 9 studies), and for prior AF was 1.28 (95% confidence interval, 1.16 to 1.40; I 2 =24%; 4 studies). The sensitivity analysis of new AF studies adjusting for confounding factors did not show a decrease in risk of death. Conclusions—: 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.
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“For example, recent meta-analyses have shown that patients with heart failure and myocardial infarction have worse outcomes if they also have AF.29, 30”
From Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study (2014) · cites this paper as [30]
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“AF is known to co-exist and interact with other conditions contributing to a worse prognosis than for individuals without AF.”
From Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study (2014) · cites this paper as [30]
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Metadata
- Authors
- Jabre, P., Roger, V. L., Murad, M. H., Chamberlain, A. M., Prokop, L., Adnet, F., & Jouven, X.
- Affiliations
- Mayo Clinic (US)
- From the Department of Health Sciences Research (P.J., V.L.R., A.M.C.), Knowledge and Encounter Research Unit (M.H.M.), and Mayo Clinic Library System (L.P.), Mayo Clinic, Rochester, MN; Department of Emergency Medicine, Avicenne University Medical Center, Assistance Publique–Hôpitaux de Paris, Bobigny, France (F.A.); SAMU de Paris, Paris–Descartes University, Paris, France (P.J.); and INSERM, U970, Cardiovascular Epidemiology, Paris–Descartes University, Paris, France (P.J., X.J.).
- Venue
- Circulation
- Published
- 2011-04-19
- Volume
- 123
- Issue
- 15
- Pages
- 1587-1593
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3082773
- OpenAlex
- W2041453711
- Cited by
- 314
- References
- 60
- Citations by year
- 2026: 18 · 2025: 15 · 2024: 16 · 2023: 24 · 2022: 18 · 2021: 32 · 2020: 23 · 2019: 25 · 2018: 14 · 2017: 20 · 2016: 14 · 2015: 23 · 2014: 22 · 2013: 18 · 2012: 25
- FWCI
- 15.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Institut National de la Santé et de la Recherche Médicale
- Société Française de Médecine d'Urgence
- Shandong First Medical University
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL59205, R01HL059205)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR030582, AR30582)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- atrial fibrillation, myocardial infarction, mortality risk, prognosis, acute myocardial infarction
- MeSH terms
- Adult, Atrial Fibrillation, Humans, Myocardial Infarction, Risk Factors
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