Atrial fibrillation as a prognostic indicator of myocardial infarction and cardiovascular death: a systematic review and meta-analysis

作者：He, Wenqi; Chu, Yingjie^*

来源：Scientific Reports, 2017, 7(1): 3360.

DOI：10.1038/s41598-017-03653-5

• SUDDEN CARDIAC DEATH
• COMPETING-RISK ANALYSIS
• HEART-FAILURE
• FOLLOW-UP
• EPIDEMIOLOGIC FEATURES
• RANDOMIZED EVALUATION
• ATHEROSCLEROSIS-RISK
• ORAL ANTICOAGULANT
• ISCHEMIC-STROKE
• ARTERY-DISEASE

This study aimed to investigate whether atrial fibrillation (AF) predicts myocardial infarction (MI) or cardiovascular (CV) death. AF is a well-established risk factor for thrombotic stroke and all-cause mortality. PubMed, EmBase, and Cochrane Central were searched for articles comparing the incidence rates of MI, CV death, or CV events between AF and non-AF patients. Relative risk ratio (RR) was used as effect estimate. Crude and adjusted RRs were calculated. Data were pooled using a random-effects model. The meta-analysis included 27 studies. In the unadjusted analysis, AF patients had a nonsignificant trend toward a higher risk of MI compared with non-AF patients; however, a significant association was found. The crude data analysis showed that AF was associated with increased risk of CV death (P < 0.05) and CV events (P < 0.05). These associations remained significant after pooling data from adjusted models (CV death: RR = 1.95, 95% CI 1.51-2.51, P < 0.05; CV events: RR = 2.10, 95% CI 1.50-2.95, P < 0.05). These results showed that AF is an independent risk factor for MI, CV death, and CV events.

• 出版日期2017-6-13
• 单位河南省人民医院