Impact of Atrial Fibrillation on In-Hospital Mortality and Stroke in Acute Aortic Syndromes

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Am J Med. 2021 Jul 6:S0002-9343(21)00415-0. doi: 10.1016/j.amjmed.2021.06.012. Online ahead of print.

ABSTRACT

BACKGROUND: Acute aortic syndromes may present with a number of cardiovascular complications, including atrial fibrillation. We assessed the prevalence of atrial fibrillation in patients presenting with acute aortic syndromes and evaluated atrial fibrillation’s association with in-hospital mortality and stroke.

METHODS: Consecutive patients with acute aortic syndromes admitted to a single tertiary care center from January 2015 to March 2020 were included. We identified patients with atrial fibrillation on the presenting electrocardiogram (ECG).

RESULTS: A total of 309 patients with acute aortic syndromes were included in our analyses: 148 (48%) presented with Stanford type A and 161 (52%) with Stanford type B acute aortic syndromes. Twenty-seven (8.7%) patients had atrial fibrillation on the presenting ECG: 12 (44%) with type A and 15 (56%) with type B acute aortic syndromes. Patients with atrial fibrillation were older, more likely to be white, had a higher frequency of history of cancer, peripheral artery disease, cerebrovascular disease, and heart failure with preserved ejection fraction compared with those without atrial fibrillation. Acute aortic syndromes patients with atrial fibrillation had higher frequencies of in-hospital mortality compared to those without atrial fibrillation (40.7% vs. 12.4%, p<0.0001). However, stroke frequencies did not differ between the two groups.

CONCLUSION: In patients presenting with acute aortic syndromes and atrial fibrillation, we observed higher frequencies of in-hospital mortality, without differences in the frequencies of stroke.

PMID:34242621 | DOI:10.1016/j.amjmed.2021.06.012