A Review of the Relationship of Atrial Fibrillation and Acute Coronary Syndrome

Abstract Purpose of Review Patients with co-morbid acute coronary syndromes (ACS) and atrial fibrillation (AF) are less likely to receive appropriate therapies and more likely to experience adverse outcomes than those in sinus rhythm. This review of current research findings on the bidirectional relationship between AF and ACS encompasses risk factors for one disease progressing to the other, corresponding patient outcomes, and important implications for clinicians. Recent findings Clinicians may be able to stratify ACS patients by clinical characteristics, diagnostic tests, and gender to identify those at increased risk for development of AF. There is evidence for differing treatment efficacy among oral anticoagulant regimens in patients with comorbid AF and ACS. Recent research suggests AF is a risk factor for development of acute coronary syndromes, specifically myocardial infarction, and is a marker for greater disease severity (e.g, ACS, heart failure, renal failure) compared to those in sinus rhythm. Summary Initiation and maintenance of antithrombotic regimens in high-risk patients with comorbid AF and ACS is crucial, but not currently routine. The evidence for additional therapies for interrupting their bidirectional relationship is based on observationa...
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research