Impact of atrial fibrillation on prognosis of patients with acute coronary syndrome
LIU Jun-tong
Han Xue-xue
ZHANG Tian-xing
XIA Jing-gang
Abstract：Objective To explore the correlation between atrial fibrillation(AF)and the prognosis of patients with acute coronary syndrome(ACS).Methods A retrospective cohort study was conducted.A total of 1680 patients diagnosed with ACS at Xuanwu Hospital of Capital Medical University from January 2018 to December 2020 were included.The patients were divided into the group with AF before discharge and the group without AF before discharge based on whether they had AF before discharge.The baseline data and the occurrence results of major adverse cardiovascular and cerebrovascular events(MACCE)within 1 year after discharge were recorded.The survival curve was plotted using the Kaplan-Meier method in survival analysis to analyze the differences in the occurrence of MACCE within 1 year after discharge between the two groups.Cox regression analysis was used to investigate the impact of AF on the occurrence of MACCE after discharge in ACS patients.Results The one-year incidence of MACCE after discharge was 17.39%in the group with pre-discharge AF,with a mortality rate of 6.52%;in the group without pre-discharge AF,the corresponding rates were 7.57%for MACCE and 1.53%for mortality.A statistically significant difference was observed between the two groups(P<0.05),which remained significant in the Log-rank test(P<0.05).However,after adjustment for potential confounders,the association between pre-discharge AF and the risk of MACCE no longer reached statistical significance.Cox regression analysis did not find that AF had an independent impact on the prognosis of ACS patients.Hypersensitive C reactive protein(hs-CRP)(HR=1.024,95%CI 1.009-1.039)and gastrointestinal bleeding during hospitalization(HR=129.976,95%CI 8.023-2105.663)were verified by the Bootstrap method and the regression coefficient B was 4.928(95%Bootstrap CI 0.000-4.928,P=0.002),which was an independent risk factor for MACCE within one year after discharge and the result was statistically significant(P<0.05).Conclusions AF has no statistically significant impact on the clinical prognosis of ACS patients.Elevated hs-CRP levels and gastrointestinal bleeding during hospitalization are the independent risk factors for MACCE in ACS patients within one year after discharge.
Keywords：Acute coronary syndromeAtrial fibrillationPrognosis
Publication Date：2025-10-20
Online Publishing Date：2025-10-30(First online date of this platform, not the publication date of the document)
Pages：6( 937-942 )