New-Onset Atrial Fibrillation Complicating Acute Myocardial Infarction in China

Study Overview
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Brief Summary
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To investigate the prognostic impacts of the atrial fibrillation burden (AFb) in acute myocardial infarction (AMI) patients who developed paroxysmal new-onset atrial fibrillation (NOAF) during the index AMI hospitalization.

Detailed Description
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In the present study, investigators retrospectively reviewed the medical records of all acute MI patients who were admitted to the coronary artery unit (CCU) of Shanghai Tenth People's Hospital, KaiFeng Central Hospital, and the First Affiliated Hospital of Zhengzhou University between January 2014 and January 2022. All patients will routinely receive continuous electronic monitoring (CEM) throughout their hospital stay to detect cardiac arrhythmias including the AF events. Of these, patients with AMI without a history of AF who developed a first documented AF episode will be considered for inclusion. The AFb is measured as a percentage (%) by dividing the total AF duration by the total CEM duration.

Official Title
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The Prognostic Impacts and Clinical Utility of the Characteristics of New-onset Atrial Fibrillation Complicating Acute Myocardial Infarction in China

Conditions
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New Onset Atrial Fibrillation, Acute Myocardial Infarction

Intervention / Treatment
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* Device: continuous electronic monitor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients hospitalized for AMI including both STEMI and NSTEMI between January 2014 and January 2022 at the CCU department of Shanghai Tenth People's Hospital, KaiFeng Central Hospital, and the First Affiliated Hospital of Zhengzhou University. Patients who developed a first documented AF (NOAF) during the index AMI hospitalization； Adult patients (>18 years old). Exclusion Criteria: Patients with a medical history of pre-existing AF; Patients with a medical history of rheumatic valvular disease; Patients with a medical history of sick sinus syndrome; Patients undergoing emergent coronary artery bypass surgery; Patients' medical records with serious deficiencies and CEM data cannot be retrieved;

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Post-MI NOAF with low AF burden<br>Patients with post-MI NOAF who had a AF burden<10.87%. The cut-off value of AF burden of 10.87% was identified based on our previous work. | Device: continuous electronic monitor<br>* All patients with MI hospitalized in the CCU department of Shanghai Tenth People's Hospital, KaiFeng Central Hospital, and the First Affiliated Hospital of Zhengzhou University will receive 24-hour continuous cardiac monitoring until discharge.<br>* Other names: Philips IntelliVue MP40, Netherlands;|
| Post-MI NOAF with high AF burden<br>Patients with post-MI NOAF who had a AF burden≥10.87%. | Device: continuous electronic monitor<br>* All patients with MI hospitalized in the CCU department of Shanghai Tenth People's Hospital, KaiFeng Central Hospital, and the First Affiliated Hospital of Zhengzhou University will receive 24-hour continuous cardiac monitoring until discharge.<br>* Other names: Philips IntelliVue MP40, Netherlands;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| All-cause death | Death from any cause | From the time of AMI discharge until occurrence of an outcome of interest, death, or loss to follow up, maximum up to 10 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiovascular death | Death from cardiovascular causes | From the time of AMI discharge until occurrence of an outcome of interest, death, or loss to follow up, maximum up to 10 years | 
| Recurrent myocardial infarction | Rehospitalization for myocardial infarction | From the time of AMI discharge until occurrence of an outcome of interest, death, or loss to follow up, maximum up to 10 years | 
| Heart failure hospitalization | HF hospitalization was based on clinical symptoms such as dyspnea and fatigue, and signs of peripheral or pulmonary edema that required hospitalization for intravenous diuretic treatment | From the time of AMI discharge until occurrence of an outcome of interest, death, or loss to follow up, maximum up to 10 years | 
| Ischemic stroke | Ischemic stroke was identified as the presence of a new focal neurologic deficit thought to be ischemic in origin, with signs or symptoms lasting> 24 hours, and was validated according to radiographic imaging test. | From the time of AMI discharge until occurrence of an outcome of interest, death, or loss to follow up, maximum up to 10 years | 
| Major bleeding | Bleeding event with a Bleeding Academic Research Consortium (BARC) classification of types 3 or 5. | From the time of AMI discharge until occurrence of an outcome of interest, death, or loss to follow up, maximum up to 10 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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myocardial infarction, new-onset atrial fibrillation, atrial fibrillation burden, mortality