Atrial fibrillation, intra-ventricular thrombus, and other anticoagulant indications relationship with adverse outcomes in acute anterior myocardial infarction patients

Journal of cardiology
Asma BourezgCIRCUS Investigators

Abstract

The aim of this study was to assess the predictive value of atrial fibrillation (AF), left ventricular thrombus (LVT), and other oral anticoagulant (OAC) indications on 1-year major adverse cardio-cerebrovascular events (MACCE) and bleeding in acute anterior ST-elevated myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). Our study population included 969 anterior STEMI patients referred for PPCI from the prospective multicenter CIRCUS trial. Patients with a formal indication of OAC within the first year were compared to those without indication. A total of 161 (16.6%) patients were eligible for OAC after anterior STEMI mainly for AF (51.5%) and LVT (39.7%). This group had a higher morbidity profile despite similar reperfusion settings - 67% of them were treated with OAC. At 1 year, OAC indication was associated with a significant increase in MACCE rate [OR 3.37 95% CI (2.36;4.82) p<0.001] as well as bleeding [OR=1.96 95% CI (1.09;3.50) p=0.02]. After adjustment for principal confounders, OAC indication remained strongly associated with MACCE [HR 3.40 (1.26;9.14) p=0.016]. In a prospective cohort of anterior STEMI, AF, LVT, and other OAC indications were present upon discharge in ...Continue Reading

References

Jul 19, 1990·The New England Journal of Medicine·P SmithI Holme
Aug 25, 2001·The New England Journal of Medicine·S YusufUNKNOWN Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Nov 12, 2003·The American Journal of Cardiology·Kunihiro KinjoUNKNOWN Osaka Acute Coronary Insufficiency Study (OACIS) Group
Jul 7, 2009·The American Journal of Cardiology·Jane S SaczynskiRobert J Goldberg
Nov 15, 2011·The New England Journal of Medicine·Jessica L MegaUNKNOWN ATLAS ACS 2–TIMI 51 Investigators
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Sep 1, 2015·The New England Journal of Medicine·Thien-Tri CungMichel Ovize
Dec 14, 2016·The New England Journal of Medicine·C Michael GibsonKeith A Fox

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Aphasia

Aphasia affects the ability to process language, including formulation and comprehension of language and speech, as well as the ability to read or write. Here is the latest research on aphasia.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.