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Title: Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention.
Austin Authors: Batchelor, Riley J;Dinh, Diem;Noaman, Samer;Brennan, Angela;Clark, David J ;Ajani, Andrew;Freeman, Melanie;Stub, Dion;Reid, Christopher M;Oqueli, Ernesto;Yip, Thomas;Shaw, James;Walton, Antony;Duffy, Stephen J;Chan, William
Affiliation: Cardiology
Department of Medicine, University of Melbourne, Melbourne, Vic, Australia
Monash University, Melbourne, Vic, Australia
Department of Cardiology, Alfred Health, Melbourne, Vic, Australia
Department of Cardiology, Western Health, Melbourne, Vic, Australia
Curtin University, Perth, WA, Australia
Department of Cardiology, Ballarat Health Services, Ballarat, Vic, Australia
Deakin University, Geelong, Vic, Australia
Department of Cardiology, Barwon Health, Geelong, Vic, Australia
Monash University, Melbourne, Vic, Australia
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia
Department of Cardiology, Eastern Health, Melbourne, Vic, Australia
Issue Date: May-2022
Date: 2022-02-04
Publication information: Heart, Lung & Circulation 2022; 31(5): 638-646
Abstract: Approximately 5-10% of patients presenting for percutaneous coronary intervention (PCI) have concurrent atrial fibrillation (AF). To what extent AF portends adverse long-term outcomes in these patients remains to be defined. We analysed data from the multicentre Melbourne Interventional Group Registry from 2014-2018. Patients were identified as being in AF or sinus rhythm (SR) at the commencement of PCI. The primary endpoint was long-term mortality, obtained via linkage with the National Death Index. 13,286 procedures were included, with 800 (6.0%) patients in AF and 12,486 (94.0%) in SR. Compared to SR, patients with AF were older (72.9±10.9 vs 64.1±12.0 p<0.001) and more likely to have comorbidities including diabetes mellitus (31.3% vs 25.0% p<0.001), hypertension (74.4% vs 65.1% p<0.001) and moderate to severe left ventricular systolic dysfunction (36.6% vs 19.5% p<0.001). Atrial fibrillation was associated with an increased risk of in-hospital mortality (11.0% vs 2.5% p<0.001) and MACE (composite of all-cause mortality, myocardial infarction, or target vessel revascularisation) (11.9% vs 4.2% p<0.001). In-hospital major bleeding was more common in the AF group (3.1% vs 1.0% p<0.001). On Cox proportional hazards modelling, AF was an independent predictor of long-term mortality (adjusted HR 1.38 95% CI 1.11-1.72 p<0.004) at a mean follow-up of 2.3±1.5 years. Preprocedural AF is common among patients presenting for PCI. Preprocedural AF is associated with high-rates of comorbid illnesses and portends higher risk of short- and long-term outcomes including mortality underscoring the need for careful evaluation of its risks prior to PCI.
DOI: 10.1016/j.hlc.2021.12.013
Journal: Heart, Lung & Circulation
PubMed URL: 35125322
PubMed URL:
Type: Journal Article
Subjects: Acute coronary syndrome
Atrial fibrillation
Clinical outcomes
Percutaneous coronary intervention
Appears in Collections:Journal articles

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