Clinical characteristics, management and outcomes of patients with acute coronary syndrome and atrial fibrillation: real-world data from two nationwide registries in Italy

Background Atrial fibrillation is common in the setting of acute coronary syndromes (ACS) although its impact on ACS remains controversial. Aim To describe in-hospital management of patients with atrial fibrillation and ACS evaluating the impact of atrial fibrillation on in-hospital and mid-term outcome. Methods We analysed the data of two prospective multicentre nationwide registries (IN-ACS Outcome and MANTRA) to assess clinical characteristics, management, and outcomes of patients with ACS and atrial fibrillation. Study outcomes included death from any cause and a composite end-point of death/re-infarction/stroke/major bleeding within index admission and 6 months’ follow-up. Results Out of 12ā€Š288 ACS patients, 1236 (10.1%) had atrial fibrillation at admission or developed it during hospitalization. Atrial fibrillation patients were older, more often female, and had higher burden of comorbidities. In-hospital mortality was higher among atrial fibrillation patients (8.7 vs. 2.4%, Pā€Š
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research

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AbstractPurpose of ReviewWith the aging population, atrial fibrillation (AF) associations with both stroke and dementia have become a priority for the healthcare system. The purpose of this paper is to review the emerging role of clinical scores and biomarkers in the risk stratification of AF patients for risk of stroke and risk of dementia.Recent FindingsAF is the most common arrhythmia in the aging population and a common comorbidity in atherosclerotic disease and heart failure. In this review, we identified 34 most relevant papers that specifically address the role of biomarkers in risk-stratifying patients with AF with...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
ConclusionAcross geriatric subgroups, apixaban was consistently associated with the most favourable benefit-risk profile and should therefore be preferred in geriatric patients with AF. However, research gaps on the impact of increased falling risk, frailty and baseline dementia were identified, requiring careful consideration while awaiting more results.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion Our study highlights how DOACs are a safe and effective option for anticoagulation, even in frail elderly people; the introduction of these drugs is leading to an increased use of anticoagulation therapy in this population. Prospective trials will be needed to reinforce these results and to consider new variables in the thrombotic and hemorrhagic risk scores underlying the prescription of DOACs.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research
Conclusion In patients with cancer and atrial fibrillation, direct oral Xa inhibitors have a similar efficacy and may be safer compared with warfarin. These results are consistent both in patients with active cancer and history of cancer.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research
Conclusion LAAO is an efficient and safe option for the prevention of cardioembolic stroke in patients with NVAF, high thromboembolic risk and contraindication to OAC, particularly in patients with previous intracranial bleeding.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research
In this study, we examined morbidity and mortality of patients with concomitant AF and liver cirrhosis from the National Inpatient Sample database, the largest publicly available inpatient healthcare database in the United States. RESULTS: A total of 696937 patients with liver cirrhosis were included, 45745 of whom had concomitant AF (6.6%). Liver cirrhosis patients with AF had higher rates of in-hospital mortality (12.6% vs 10.3%, P
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
Authors: Gunawardene MA, Hartmann J, Jularic M, Eickholt C, Gessler N, Willems S Abstract Atrial fibrillation (AF) is the most frequent persistent cardiac arrhythmia and is associated with an increased mortality. Therefore, an effective differential treatment of patients is mandatory. After a risk stratification oral anticoagulation (OAC) should be initiated depending on the individual stroke risk of each patient. Alternatively, in the presence of contraindications for OAC and an increased risk for bleeding and/or stroke, the implantation of a left atrial appendage closure device can be considered. Symptomatic pati...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases. On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely.  When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA.    ===================================MY Comment by KEN ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion Uninterrupted DOAC is a safe and effective alternative to uninterrupted VKA during atrial fibrillation ablation.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research
Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mel...
Source: Cardiology in Review - Category: Cardiology Tags: Review Articles Source Type: research
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