P-562: Atrial fibrillation during acute myocardial infarction: association with history of hypertension:

Abstract

Atrial Fibrillation (AF) occurs in some 10% of patients with acute myocardial infarction (AMI). The aim of our study was to ascertain whether HT is associated to onset of AF during AMI.

Four hundred and twenty-two consecutive patients (mean age 66.1±12.3 years, females n=127) without chronic AF admitted to 3 coronary care units because of definite AMI were studied. Among them 193 (46%) had documented HT (duration 11.6±8.9 years). In the HT group, 32 (17%) patients had parossistic AF during the 1^st week of hospitalization while among the normotensives 16 (7%) had AF (p=0.002). At univariate logistic regression, AF (used as dichotomic dependent variable) resulted related to HT [T=3.0, p=0.003, odds ratio 2.6 (95%CL1.4-4.9)]. In the multivariable logistic regression including possible clinical confounders, age (T=2.1, p=0.03), presence of heart failure during the 1^st week of hospitalization (T=3.8, p<0.0001) and HT [T=2.1, p=0.03, odds ratio 2.1 (CL 1.1-4.3)] resulted independently associated to onset of AF, while gender, diabetes mellitus, CK-MB peak and thrombolytic therapy, were rejected from the model. Inclusion of drug treatments in the logistic model did not modify the results. Blood pressure values on admission did not result related to AF.

In conclusion, this study shows that onset of AF during AMI is more frequent in patients with HT. This association is independent from haemodinamic changes and other clinical confounders.

atrial fibrillation, myocardial infarction, hypertension