Tools
Tools
Ntaios, G, Sagris, D, Buckley, BJR, Harrison, SL, Abdul-Rahim, A, Austin, P and Lip, GYH (2023) Risk of myocardial infarction and ischemic stroke in individuals with first-diagnosed paroxysmal vs. non-paroxysmal atrial fibrillation under anticoagulation. EP Europace, 25 (6). pp. 1-6. ISSN 1099-5129
|
Text
Risk of myocardial infarction and ischemic stroke in individuals with first-diagnosed paroxysmal vs. non-paroxysmal atrial f.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. Download (579kB) | Preview |
Abstract
Aims There is conflicting evidence on whether the type of atrial fibrillation (AF) is associated with risk of cardiovascular events, including acute myocardial infarction (MI) and ischemic stroke. The aim of the present study was to investigate whether the risk of MI and ischemic stroke differs between individuals with first-diagnosed paroxysmal vs. non-paroxysmal AF treated with anticoagulants. Methods De-identified electronic medical records from the TriNetX federated research network were used. Individuals with a new and results diagnosis of paroxysmal AF who had no evidence of other types of AF in their records were 1:1 propensity score-matched with individuals with non-paroxysmal AF, defined as persistent or chronic AF, who had no evidence of other types of AF in their records. All patients were followed for three years for the outcomes of MI and ischemic stroke. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). In the propensity-matched cohort, among 24 848 well-matched AF individuals [mean age 74.4 ± 10.4; 10 101 (40.6%) female], 410 (1.7%) were diagnosed with acute MI and 875 (3.5%) with ischemic stroke during the three-year follow-up. Individuals with paroxysmal AF had significantly higher risk of acute MI (HR: 1.65, 95%CI: 1.35–2.01) compared to those with non-paroxysmal AF. First diagnosed paroxysmal AF was associated with higher risk of non-ST elevation MI (nSTEMI) (HR: 1.89, 95%CI: 1.44–2.46). No significant association was observed between the type of AF and risk of ischemic stroke (HR: 1.09, 95%CI: 0.95–1.25). Conclusion Patients with first-diagnosed paroxysmal AF had higher risk of acute MI compared to individuals with non-paroxysmal AF, attributed to the higher risk of nSTEMI among patients with first-diagnosed paroxysmal AF. There was no significant association between type of AF and risk of ischemic stroke.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans; Atrial Fibrillation; Myocardial Infarction; Anticoagulants; Risk Factors; Aged; Aged, 80 and over; Middle Aged; Female; Male; Stroke; Non-ST Elevated Myocardial Infarction; Ischemic Stroke; Atrial fibrillation; Ischemic stroke; Myocardial infarction; Paroxysmal; Permanent; Humans; Female; Middle Aged; Aged; Aged, 80 and over; Male; Atrial Fibrillation; Ischemic Stroke; Stroke; Non-ST Elevated Myocardial Infarction; Myocardial Infarction; Anticoagulants; Risk Factors; 1103 Clinical Sciences; Cardiovascular System & Hematology |
| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
| Divisions: | Nursing & Allied Health Sport & Exercise Sciences |
| Publisher: | Oxford University Press (OUP) |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 04 Sep 2023 13:27 |
| Last Modified: | 04 Sep 2023 13:30 |
| DOI or ID number: | 10.1093/europace/euad143 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/21204 |
 |
View Item |