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Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population Cardiovascular Mortality After Type 1 and Type 2 Myocardial Infarction in Young Adults Clinical Characteristics and Outcomes of STEMI Patients With Cardiogenic Shock and Cardiac Arrest Utility and Challenges of an Early Invasive Strategy in Patients Resuscitated From Out-of-Hospital Cardiac Arrest Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Cardiogenic Shock Percutaneous Support Devices for Percutaneous Coronary Intervention Eruptive Calcified Nodules as a Potential Mechanism of Acute Coronary Thrombosis and Sudden Death Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Policy Statement From the American Heart Association Evaluation and Management of Nonculprit Lesions in STEMI ST-Segment Elevation Myocardial Infarction Patients in the Coronary Care Unit Is it Time to Break Old Habits?

Original Research2018 Mar;107(3):233-240.

JOURNAL:Clin Res Cardiol. Article Link

Prognostic impact of atrial fibrillation in cardiogenic shock complicating acute myocardial infarction: a substudy of the IABP-SHOCK II trial

de Waha S, Schoene K, Thiele H et al. Keywords: acute myocardial infarction; atrial fibrillation; cardiogenic shock; IABP-SHOCK II trial; prognosis

ABSTRACT


BACKGROUND - Aim of the current study was to analyse the impact of atrial fibrillation (AF) on prognosis in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI), which has never been investigated yet.


METHODS - The current analysis is a substudy of the IABP-SHOCK II trial. Patients were grouped according to the presence or absence of AF. The primary endpoint was all-cause mortality at 30-day follow-up. Secondary endpoints included all-cause mortality, recurrent myocardial infarction, repeat revascularisation, and stroke at 12 months.

 

RESULTS - AF was documented in 28.2% (n = 169) of all 600 patients initially enrolled in the IABP-SHOCK II trial. There were no significant differences with respect to mortality at 30 days and 12 months between patients with and without AF (p = 0.81, p = 0.74). Similarly, the rates of recurrent myocardial infarction, repeat revascularisation, and stroke did not differ between groups (all p > 0.05). There was no interaction of intraaortic balloon counterpulsation (IABP) and no IABP in patients with or without AF with respect to clinical outcome at 30 days and 12 months (p > 0.05).

 

CONCLUSION - AF is not associated with clinical outcome at 30 days and 12 months in CS complicating AMI.