Martínez Membrive, María JoséSubirana, IsaacFadeuilhe, EdgarRueda, FerranCarreras-Mora, JoséOliveras, TeresaGiralt Borrell, TeresaLabata, CarlosFerrer, MarcEl Ouaddi, NabilMontero, SantiagoElosua Llanos, RobertoRibas Barquet, NúriaBayés-Genís, AntoniGarcía-García, Cosme2025-01-282024Martínez Membrive MJ, Subirana I, Fadeuilhe E, Rueda F, Carreras-Mora J, Oliveras T, et al. Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke. Eur Heart J Acute Cardiovasc Care. 2024 Jun 3:zuae072. DOI: 10.1093/ehjacc/zuae0722048-8726http://hdl.handle.net/10230/69353Data de publicació electrònica: 03-06-2024Background: Atrial fibrillation (AF) often complicates ST elevation acute myocardial infarction (STEMI), with associated risks including stroke and mortality. Anticoagulation therapy for these patients and AF prognosis remains controversial. The aim was to evaluate long-term prognosis of STEMI patients complicated with AF in the acute phase. Methods: We performed a retrospective analysis on a prospective register involving 4,184 patients admitted for STEMI to the intensive cardiac care unit of 2 tertiary centres from 2007 to 2015. Patients with pre-existing permanent AF were excluded. Out of these, 269 (6.4%) patients developed AF within the first 48 hours after STEMI and were matched with a control group based on age and left ventricular ejection fraction (LVEF). Results: After matching, a total of 470 patients were included (n=235, AF-STEMI; n=235, control group). Mean age 69.0 years, and 31.7% women. No differences were found in gender, cardiovascular risk factors or ischemic heart disease. AF-STEMI patients experienced more sustained ventricular tachycardia, advanced atrioventricular block, heart failure, and cardiogenic shock. In-hospital mortality was also higher in AF-STEMI patients (11.9% vs 7.2%, p=0.008). After 10-years follow-up, the AF-STEMI group had remained with higher mortality (50.5% vs. 36.2%; p=0.003) and a greater recurrence of AF (44.2% vs. 14.7%; p<0.001), without differences in stroke incidence (10.1% vs. 9.3%). Conclusions: As a conclusion, patients with AF complicating STEMI have higher rates of heart failure, cardiogenic shock, and in-hospital mortality. After a 10-year follow-up, they exhibit a high risk of AF recurrence and mortality, with no significant differences in stroke incidence.application/pdfeng© Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in European heart journal. Acute cardiovascular care following peer review. The version of record Martínez Membrive MJ, Subirana I, Fadeuilhe E, Rueda F, Carreras-Mora J, Oliveras T, et al. Ten-year prognosis of acute atrial fibrillation in ST-elevation myocardial infarction: recurrence and risk stroke. Eur Heart J Acute Cardiovasc Care. 2024 Jun 3:zuae072. DOI: 10.1093/ehjacc/zuae072 is available online at: http://dx.doi.org/10.1093/ehjacc/zuae072info:eu-repo/semantics/articlehttp://dx.doi.org/10.1093/ehjacc/zuae072STEMIAtrial fibrillationPrognosisStrokeinfo:eu-repo/semantics/embargoedAccess