Abstract 12073: The Association of Atrial Fibrillation and Mortality in Patients with Myocardial Infarction: a Systematic Review and Meta-Analysis
Introduction: Atrial fibrillation (AF) and myocardial infarction (MI) often coexist. The impact of AF on post MI mortality is unclear.
Hypothesis: We hypothesized that AF is associated with increased risk of death after MI.
Methods: We conducted a systematic review and meta-analysis searching MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Cochrane Database of Systematic Reviews, Ovid Health Technology Assessment, and Scopus databases to identify studies that evaluated mortality related to AF in MI patients through February 2010 in any language. Two independent reviewers determined studies eligibility and extracted methodological and outcome data. Adjusted odds ratios (ORs) were pooled across studies using the random-effects model. The I2 statistic was used to assess heterogeneity.
Results: The search identified 46 eligible studies describing 290,184 subjects. There was a significant association between AF and short-term (<30 days), mid term (31−365 days) and long-term all cause mortality (> 365 days). The respective pooled adjusted OR’s and 95% confidence intervals (CIs) were: 1.4 (1.3–1.6), I2=81%p, 20 studies; 1.7 (1.1–2.6), I2=76%, 3 studies; and 1.4 (1.3–1.6), I2=84%, 13 studies. These significant associations were also noted when analysis was stratified by whether AF had a new onset or was pre-existing at the time of presentation. The association was also significant when we evaluated cardiovascular death, although the number of studies that reported this outcome was limited.
Conclusions: Observational evidence with significant heterogeneity suggests that AF is associated with increased risk of short, mid and long-term mortality after MI.
- © 2010 by American Heart Association, Inc.