Stent Placement and the Risk of New-onset AF in Patients With AMI

Study Overview
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Brief Summary
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The benefit of a drug-eluting stent (DES) in patients with acute myocardial infarction (AMI) is controversial. This study will aim to observe the effect of a DES on the risk of new-onset AF in patients with AMI.

Detailed Description
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Acute myocardial infarction (AMI) is the leading cause of mortality in the world. Early invasive strategy with percutaneous coronary intervention (PCI) has been demonstrated to be the most effective strategy to treat AMI. Although drug-eluting stent (DES) has not shown benefits to reduce mortality rate among AMI patients compared with bare-metal stent (BMS), the use of DES in real-world is increasing because of reduced restenosis rates. AMI patients are at higher risk to develop atrial fibrillation (AF) than general population. However, whether early PCI with DES implantation is related to a reduced risk of AF still remains unclear. The purpose of this study is to investigate the association of DES implantation and the risk of AF among patients with AMI treated by early PCI.

Official Title
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The Impacts of Different Stent Types in Acute Myocardial Infarction on the Risk of Atrial Fibrillation

Conditions
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Atrial Fibrillation New Onset, Acute Myocardial Infarction

Intervention / Treatment
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* Device: DES or BMS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients were enrolled by primary diagnostic coding as acute myocardial infarction and treatment coding as receiving PCI between 2007 and 2013 in Taiwan National Health Insurance Research Database (NHIRD) Exclusion Criteria: Less than 20-years-old; Unknown sex and age Not residents in Taiwan Died during AMI admission Previous history of AF Receiving coronary artery bypass grafting (CABG), ventricular assist device (VAD), extracorporeal membrane oxygenation (ECMO), and heart transplantation during observational and/or database period No stent implantation during PCI Unknown stent types

Ages Eligible for Study
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Minimum Age: 20 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 |
| --- | --- |
| STEMI<br>Patients with STEMI treated with PCI and stent placement (DES or BMS) | Device: DES or BMS<br>* DES or BMS placement during the procedure of PCI in patients with AMI is depend on the operator's decision.<br>|
| NSTEMI<br>Patients with NSTEMI treated with PCI and stent placement (DES or BMS) | Device: DES or BMS<br>* DES or BMS placement during the procedure of PCI in patients with AMI is depend on the operator's decision.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| new-onset atrial fibrillation | new record or diagnostic claims of atrial fibrillation after hospital discharge from acute myocardial infarction | one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Atrial fibrillation, Acute myocardial infarction, Drug-eluting stent