Among the outcomes examined , the highest absolute risk increase was for heart failure .
Associations between atrial fibrillation and included outcomes were broadly consistent across subgroups and in sensitivity analyses .
Atrial fibrillation is associated with an increased risk of death and an increased risk of cardiovascular and renal disease .
OBJECTIVE To quantify the association between  atrial fibrillation and cardiovascular disease , renal disease , and death .
Incidence and prognostic significance of atrial fibrillation in acute myocardial infarction: the GISSI-3 data
BACKGROUND Atrial fibrillation is the most common supraventricular arrhythmia in patients with acute myocardial infa rct ion . Recent advances in pharmacological treatment of myocardial infa rct ion may have changed the impact of this arrhythmia . OBJECTIVE To assess the incidence and prognosis of atrial fibrillation complicating myocardial infa rct ion in a large population of patients receiving optimal treatment , including angiotensin converting enzyme ( ACE ) inhibitors .  METHODS Data were derived from the GISSI-3 trial , which included 17 944 patients within the first 24 hours after acute myocardial infa rct ion . Atrial fibrillation was recorded during the hospital stay , and follow up visits were planned at six weeks and six months . Survival of the patients at four years was assessed through census offices . RESULTS The incidence of in-hospital atrial fibrillation or flutter was 7.8 % . Atrial fibrillation was associated with indicators of a worse prognosis ( age > 70 years , female sex , higher Killip class , previous myocardial infa rct ion , treated hypertension , high systolic blood pressure at entry , insulin dependent diabetes , signs or symptoms of heart failure ) and with some adverse clinical events ( reinfa rct ion , sustained ventricular tachycardia , ventricular fibrillation ) . After adjustment for other prognostic factors , atrial fibrillation remained an independent predictor of increased in-hospital mortality : 12.6%v 5 % , adjusted relative risk ( RR ) 1.98 , 95 % confidence interval ( CI ) 1.67 to 2.34 . Data on long term mortality ( four years after acute myocardial infa rct ion ) confirmed the persistent negative influence of atrial fibrillation ( RR 1.78 , 95 % CI 1.60 to 1.99 ) . CONCLUSIONS Atrial fibrillation is an indicator of worse prognosis after acute myocardial infa rct ion , both in the short term and in the long term , even in an unselected population
Among the outcomes examined , the highest absolute risk increase was for heart failure .
Associations between atrial fibrillation and included outcomes were broadly consistent across subgroups and in sensitivity analyses .
Atrial fibrillation is associated with an increased risk of death and an increased risk of cardiovascular and renal disease .
OBJECTIVE To quantify the association between  atrial fibrillation and cardiovascular disease , renal disease , and death .