Impact of Atrial Fibrillation at the Time of Coronary Revascularization on Long-Term Outcomes: From the G-NUH Registry

Abstract

BackgroundCoronary artery disease (CAD) and atrial fibrillation (AF) frequently co-occur. They influence each other in terms of occurrence and aggravation, which has an impact on the prognosis. Meanwhile, there is a lack of reports on whether AF rhythm at the time of coronary revascularizations is related to long-term prognosis. We aimed to determine whether AF upon electrocardiography at the time of revascularization for CAD affects the patient's long-term outcome.MethodsWe observed the clinical outcomes (up to 10 years) in 7733 patients who underwent coronary intervention at two centers. Patients were divided into AF and non-AF groups on the day of the procedure, and analyses were performed after validation through propensity score matching. The primary outcome was major adverse cardiac events (MACEs) defined as a composite of all-cause mortality, spontaneous myocardial infarction, stroke, and hospitalization. Subgroup analysis was performed for different causes of hospitalization.ResultsDuring follow-up (mean: 3.8 years), the incidence and risk of MACEs did not differ between the AF and non-AF groups (23.3% vs. 36.2%, adjusted hazard ratio [HR]: 1.21, 95% confidence interval [CI]: 0.74-1.98, p = 0.443) following coronary intervention, after propensity score matching. However, the incidence of hospitalization events was higher in the AF group than that in the non-AF group (2.2% vs. 8.6%, adjusted HR: 3.28, 95% CI: 1.02-10.53, p = 0.046). Among the causes of hospitalization, the incidence of major bleeding was significantly higher in the AF group.ConclusionsThe effect of AF during coronary revascularization on the incidence of the MACEs over a mean follow-up of 3.8 years was not statistically significant. However, AF was associated with a higher incidence of hospitalization during the follow-up period. Trial Registration: ClinicalTrials.gov identifier: NCT04650529ConclusionsThe effect of AF during coronary revascularization on the incidence of the MACEs over a mean follow-up of 3.8 years was not statistically significant. However, AF was associated with a higher incidence of hospitalization during the follow-up period. Trial Registration: ClinicalTrials.gov identifier: NCT04650529