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2014, Number 2

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Med Sur 2014; 21 (2)

Fibrilación auricular como predictor de mortalidad en pacientes con infarto agudo del miocardio

Aguilar-Zapata D, González-Chon O, Bogard-Fuentes CA, Moreno-Castańeda L, Chávez-Tapia NC, García-López S

Language: Spanish
References: 15
Page: 55-61
PDF size: 146.62 Kb.


ABSTRACT

Background. Atrial fibrillation coexists with acute coronary syndromes. Predictors of atrial fibrillation in the acute coronary syndrome context are: advanced age, heart failure symptoms, and ventricular systolic dysfunction. Atrial fibrillation in association with acute coronary syndrome increases mortality secondary to cerebrovascular disease and heart failure. Aim. Describe the morbid-mortality incidence in patients with atrial fibrillation and its relation with acute coronary syndromes. Material and methods. Case-control studies conducted in the Coronary Unit of Médica Sur. Cases were defined as patients who presented with atrial fibrillation at admission or during their hospitalization. Primary outcome was mortality. Continuous variables were analyzed with Student’s-t test and categorical variables with χ2 test. An univariate and multivariate logistic regression analysis were done to identify risk factors for atrial fibrillation and death. Results. A total of 239 patients with acute coronary syndrome were included, 22 patients (9.2%) had atrial fibrillation (12 without ST elevation and 10 with ST elevation). Patients with acute coronary syndrome and atrial fibrillation were older compared with the group without atrial firbilation (68 vs. 60 years, p = 0.002). Patients with atrial fibrilation patients have diabetes more frequently (59 vs. 31%, p = 0.016), and heart failure (59 vs. 35%, p = 0.036). Risk factors for atrial fibrillation were: age older than 55 years (OR 10.5, CI 95% 1.38-79.62), diabetes (OR 3.14, CI 95% 1.28-7.7) and smoking (OR 2.66, CI 95% 0.959-7.497). Atrial fibrillation is an independent risk factor for overall mortality (OR 8.36, CI 95% 1.7-40.17). Conclusions. Atrial fibrillation in patients with acute coronary syndrome is an independent risk factor for death. Age, diabetes and smoking are associated with the presence of atrial fibrillation in this group of patients.


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