In Hospital Atrial Fibrillation is a Predictor of Long Term Stroke Event among Patients with Acute Myocardial Infarction

Manoefris Kasim, Octavia Lilyasari, Yoga Yuniadi

Abstract


Background. Atrial fibrillation (AF) is a common arrhythmia after acutemyocardial infarction (AMI).Mortality in AMI patients with AF also beenshown to be up to twice as high as for those without AF. Nonhemorrhagicstroke occurs in 0.1% to 1.3%of patients with acute myocardial infarctionwho are treatedwith thrombolytic, with substantial associated mortalityandmorbidity. The aim of this study is toelaborate correlation between inhospital AF with long term stroke event inST-elevation myocardial infarction(STEMI) patients who treated with thrombolytic .Methods. Two hundred and thirty STEMI patients (27-72 yo) treated withthrombolytic agent were studied retrospectively. The study end point wasMajor Cardio-Cerebrovascular Event (MACCE) during 3 years follow up.Results. Eleven patients experience AF episode during STEMIhospitalization. During 3 years follow up 24 patients (10.4%) experiencedMACCE which comprised of : cardiac death 4 (1.7%), fatal infarction 2(0.9%), non fatal infarction 13 (5.7%) and stroke 5 (2.2%). Independentclinical variables were not significant as a predictor for the occurrence offuture stroke event, except atrial fibrillation episode (HR 13.4; p<0.005)that was encountered during hospitalization in the setting of AMI.Conclusion. In-hospital AF in STEMI patients treated with thrombolyticagent is a predictor of long term stroke.

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