Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention
Objectives: Approximately 5–10% of patients presenting for percutaneous coronary intervention (PCI) have concurrent atrial fibrillation (AF). To what extent AF portends adverse long-term outcomes in these patients remains to be defined. Methods: We analysed data from the multicentre Melbourne Interv...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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ELSEVIER SCIENCE INC
2022
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93765 |
| _version_ | 1848765783692279808 |
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| author | Batchelor, R.J. Dinh, D. Noaman, S. Brennan, A. Clark, D. Ajani, A. Freeman, M. Stub, D. Reid, Christopher Oqueli, E. Yip, T. Shaw, J. Walton, A. Duffy, S.J. Chan, W. |
| author_facet | Batchelor, R.J. Dinh, D. Noaman, S. Brennan, A. Clark, D. Ajani, A. Freeman, M. Stub, D. Reid, Christopher Oqueli, E. Yip, T. Shaw, J. Walton, A. Duffy, S.J. Chan, W. |
| author_sort | Batchelor, R.J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objectives: Approximately 5–10% of patients presenting for percutaneous coronary intervention (PCI) have concurrent atrial fibrillation (AF). To what extent AF portends adverse long-term outcomes in these patients remains to be defined. Methods: We analysed data from the multicentre Melbourne Interventional Group Registry from 2014–2018. Patients were identified as being in AF or sinus rhythm (SR) at the commencement of PCI. The primary endpoint was long-term mortality, obtained via linkage with the National Death Index. Results: 13,286 procedures were included, with 800 (6.0%) patients in AF and 12,486 (94.0%) in SR. Compared to SR, patients with AF were older (72.9±10.9 vs 64.1±12.0 p<0.001) and more likely to have comorbidities including diabetes mellitus (31.3% vs 25.0% p<0.001), hypertension (74.4% vs 65.1% p<0.001) and moderate to severe left ventricular systolic dysfunction (36.6% vs 19.5% p<0.001). Atrial fibrillation was associated with an increased risk of in-hospital mortality (11.0% vs 2.5% p<0.001) and MACE (composite of all-cause mortality, myocardial infarction, or target vessel revascularisation) (11.9% vs 4.2% p<0.001). In-hospital major bleeding was more common in the AF group (3.1% vs 1.0% p<0.001). On Cox proportional hazards modelling, AF was an independent predictor of long-term mortality (adjusted HR 1.38 95% CI 1.11–1.72 p<0.004) at a mean follow-up of 2.3±1.5 years. Conclusions: Preprocedural AF is common among patients presenting for PCI. Preprocedural AF is associated with high-rates of comorbid illnesses and portends higher risk of short- and long-term outcomes including mortality underscoring the need for careful evaluation of its risks prior to PCI. |
| first_indexed | 2025-11-14T11:40:44Z |
| format | Journal Article |
| id | curtin-20.500.11937-93765 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:40:44Z |
| publishDate | 2022 |
| publisher | ELSEVIER SCIENCE INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-937652024-01-10T01:52:51Z Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Batchelor, R.J. Dinh, D. Noaman, S. Brennan, A. Clark, D. Ajani, A. Freeman, M. Stub, D. Reid, Christopher Oqueli, E. Yip, T. Shaw, J. Walton, A. Duffy, S.J. Chan, W. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Atrial fibrillation Acute coronary syndrome Percutaneous coronary intervention Clinical outcomes WARFARIN IMPACT RISK RIVAROXABAN ASSOCIATION DABIGATRAN APIXABAN DISEASE TRIALS Acute coronary syndrome Atrial fibrillation Clinical outcomes Percutaneous coronary intervention Atrial Fibrillation Hemorrhage Humans Myocardial Infarction Percutaneous Coronary Intervention Registries Treatment Outcome Humans Atrial Fibrillation Myocardial Infarction Hemorrhage Treatment Outcome Registries Percutaneous Coronary Intervention Objectives: Approximately 5–10% of patients presenting for percutaneous coronary intervention (PCI) have concurrent atrial fibrillation (AF). To what extent AF portends adverse long-term outcomes in these patients remains to be defined. Methods: We analysed data from the multicentre Melbourne Interventional Group Registry from 2014–2018. Patients were identified as being in AF or sinus rhythm (SR) at the commencement of PCI. The primary endpoint was long-term mortality, obtained via linkage with the National Death Index. Results: 13,286 procedures were included, with 800 (6.0%) patients in AF and 12,486 (94.0%) in SR. Compared to SR, patients with AF were older (72.9±10.9 vs 64.1±12.0 p<0.001) and more likely to have comorbidities including diabetes mellitus (31.3% vs 25.0% p<0.001), hypertension (74.4% vs 65.1% p<0.001) and moderate to severe left ventricular systolic dysfunction (36.6% vs 19.5% p<0.001). Atrial fibrillation was associated with an increased risk of in-hospital mortality (11.0% vs 2.5% p<0.001) and MACE (composite of all-cause mortality, myocardial infarction, or target vessel revascularisation) (11.9% vs 4.2% p<0.001). In-hospital major bleeding was more common in the AF group (3.1% vs 1.0% p<0.001). On Cox proportional hazards modelling, AF was an independent predictor of long-term mortality (adjusted HR 1.38 95% CI 1.11–1.72 p<0.004) at a mean follow-up of 2.3±1.5 years. Conclusions: Preprocedural AF is common among patients presenting for PCI. Preprocedural AF is associated with high-rates of comorbid illnesses and portends higher risk of short- and long-term outcomes including mortality underscoring the need for careful evaluation of its risks prior to PCI. 2022 Journal Article http://hdl.handle.net/20.500.11937/93765 10.1016/j.hlc.2021.12.013 English http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1136372 ELSEVIER SCIENCE INC restricted |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Atrial fibrillation Acute coronary syndrome Percutaneous coronary intervention Clinical outcomes WARFARIN IMPACT RISK RIVAROXABAN ASSOCIATION DABIGATRAN APIXABAN DISEASE TRIALS Acute coronary syndrome Atrial fibrillation Clinical outcomes Percutaneous coronary intervention Atrial Fibrillation Hemorrhage Humans Myocardial Infarction Percutaneous Coronary Intervention Registries Treatment Outcome Humans Atrial Fibrillation Myocardial Infarction Hemorrhage Treatment Outcome Registries Percutaneous Coronary Intervention Batchelor, R.J. Dinh, D. Noaman, S. Brennan, A. Clark, D. Ajani, A. Freeman, M. Stub, D. Reid, Christopher Oqueli, E. Yip, T. Shaw, J. Walton, A. Duffy, S.J. Chan, W. Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention |
| title | Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention |
| title_full | Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention |
| title_fullStr | Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention |
| title_full_unstemmed | Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention |
| title_short | Adverse 30-Day Clinical Outcomes and Long-Term Mortality Among Patients With Preprocedural Atrial Fibrillation Undergoing Percutaneous Coronary Intervention |
| title_sort | adverse 30-day clinical outcomes and long-term mortality among patients with preprocedural atrial fibrillation undergoing percutaneous coronary intervention |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Atrial fibrillation Acute coronary syndrome Percutaneous coronary intervention Clinical outcomes WARFARIN IMPACT RISK RIVAROXABAN ASSOCIATION DABIGATRAN APIXABAN DISEASE TRIALS Acute coronary syndrome Atrial fibrillation Clinical outcomes Percutaneous coronary intervention Atrial Fibrillation Hemorrhage Humans Myocardial Infarction Percutaneous Coronary Intervention Registries Treatment Outcome Humans Atrial Fibrillation Myocardial Infarction Hemorrhage Treatment Outcome Registries Percutaneous Coronary Intervention |
| url | http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93765 |