Atrial fibrillation (AF) is the most prevalent arrhythmia in man. Incidence increases with age, risk of ischemic stroke as a result of AF disproportionally so. Anticoagulation is therefore one of the cornerstones of treatment. Perceived severity of bleeding risk on anticoagulants is, however, one of the main reasons that the elderly population at highest risk is relatively undertreated.This article describes both risks for the traditional vitamin K antagonists,in addition to the new direct thrombin and factor Xa antagonists.
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The impact of new-onset atrial fibrillation in the setting of acute coronary syndrome.
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Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Kent and Medway Medical School, Canterbury, Kent, UK; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China.
Approximately 10 % of patients who have suffered from myocardial infarction develop new-onset atrial fibrillation (AF). Coronary artery disease implicating atrial branches has been associated with AF. The following variables have been associated with new-onset AF in the setting of acute coronary syndrome: older age, history of hypertension, history of angina, history of stroke, chronic renal failure, body mass index, no statin use, worse nutritional status, worse Killip class, admission heart rate ≥ 85 bpm, complete atrioventricular block, Glasgow prognostic score, Syntax score, CHEST score > 3, PRECISE-DAPT score ≥ 25, left ventricular ejection fraction ≤40 %, increased left atrial diameter, E/E' ratio > 12, epicardial fat tissue thickness, and thrombolysis in myocardial infarction flow <3.
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HRB Clinical Research Facility Galway, School of Medicine, University of Galway, Galway, Ireland.
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