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Prognostic impact of new onset atrial fibrillation in acute non-ST elevation myocardial infarction data from the RICO survey

New onset atrial fibrillation (AF) is a common complication of acute myocardial infarction (MI), with a prevalence ranging of from 7–18%, and is associated with a higher incidence of in-hospital congestive heart failure. AF occurs in patients who are older with severe coronary artery disease and is associated with higher 30 day and one year mortality rates than for those patients without AF.1–4

However, most studies have been performed on data collected from patients with ST elevation myocardial infarction (STEMI). In the present study, we examined the characteristics and in-hospital outcome for a non-selected population, hospitalised for non-ST elevation myocardial infarction (NSTEMI) and included in the French regional RICO survey.

From 1 January 2001 to 31 July 2003 pre-hospital as well as in-hospital data from 504 patients, hospitalised for acute NSTEMI in one region of eastern France, were analysed. All the cardiology departments of the region, five public hospitals and one private clinic, in charge of cardiac emergencies, participated in the study.

All patients included in the study presented with NSTEMI. The diagnoses were based on: an increase in troponin concentrations to the upper limit of normal (ULN) or creatine kinase myocardial band ⩾ 2 ULN; NSTEMI (ST segment depression or negative T wave on ECG); patients admitted to index hospital within 24 hours following symptom onset. Patients presenting any one of the following criteria were excluded from the study: persistent ST elevation or new Q …