Temporal trends and outcomes associated with atrial fibrillation observed during acute coronary syndrome: Real-world data from the Acute Coronary Syndrome Israeli Survey (ACSIS), 2000–2013

Aharon Erez, Ilan Goldenberg, Avi Sabbag, Eyal Nof, Doron Zahger, Shaul Atar, Arthur Pollak, Idit Dobrecky-Merye, Roy Beigel, Shlomi Matetzky, Michael Glikson, Roy Beinart

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The past decade has brought major advances in therapy of patients presenting with acute coronary syndromes (ACS). Hypothesis: The outcomes of ACS patients with atrial fibrillation (AF) has improved over the years. Methods: We evaluated time-dependent changes in clinical characteristics, management strategies, and outcomes associated with AF observed during ACS hospitalization in patients enrolled in the biannual ACS Israeli Surveys (ACSIS) between 2000 and 2013. We divided the surveys into early (2000–2006) and late (2008–2013) time periods. Results: The study population comprised 13 297 ACS patients, of whom 755 (5.7%) either presented with or developed AF during the index hospitalization. The incidence of AF observed during ACS hospitalization was lower during the later period (6.2% vs 4.9%; P < 0.01). Kaplan-Meier survival analysis showed that 1-year mortality rates were significantly lower among ACS patients with and without AF who were enrolled during the later vs early survey period (log-rank P < 0.01 for the overall difference). However, AF observed among ACS patients was still associated with increased risk for in-hospital complications and 30-day and 1-year mortality during both the early and late survey periods (P < 0.05 for all comparisons). Conclusions: In 10 years, rates of AF among ACS patients have declined significantly. Yet, despite improved overall 1-year survival for patients with AF, the development of AF in this population remains an independent predictor of mortality that has not changed appreciably over the years.

Original languageEnglish
Pages (from-to)275-280
Number of pages6
JournalClinical Cardiology
Volume40
Issue number5
DOIs
StatePublished - May 2017
Externally publishedYes

Keywords

  • ACSIS registry
  • Acute coronary syndrome
  • atrial fibrillation

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