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Atrial Fibrillation in Unstable Angina

Koracevic, Goran; Andrejevic, Sladjana;
Pesic, Lela

Department of Cardiovascular Diseases, Nis, Yugoslavia

Background: Atrial fibrillation (AF), the most common chronic form of dysrrhythmia, has been shown to adversely influence prognosis in acute myocardial infarction, but the data are relatively sparse on unstable angina pectoris (UAP).

Objectives: to investigate prevalence, clinical interrelationships and possible prognostic significance of AF in UAP patients (pts).

Patients and methods: We analyzed 202 UAP pts, hospitalized in our Dept. in 2000. The average age was 63.9±11.2 years; 103 were males and 99 females. Mortality was 3.5%.

Results and discussion: AF was found in 13.0%. As expected, AF presence correlated with age (correlation coefficient=0.2225, p=0.0022). Significant correlation with female gender was surprising: corr. coef.=0.1794, p=0.0119. The strongest correlation was found with LBBB (coef. =0.4755, p<0.0001). Interestingly, no tight relation was found with presence of previous myocardial infarction as well as with diabetes mellitus (although expected). The most important finding related to inhospital prognosis: corr. coef. = 0.2539 and p=0.0003 with mortality. Namely, in UAP pts in sinus rhythm, mortality was 1.8%, but with AF it increased to 16.0%! This 9-fold excess in lethality may be partially due to limited number of pts, but it is very persuasive nevertheless.

Conclusions: 1) Atrial fibrillation is relatively common in unstable angina: every 7th patient has it. 2) AF is related to older age and female gender, as well as to some bad prognostic markers, but not all (e.g., absence of significant correlation with prior infarction and with diabetes was surprising). 3) Presence of AF multiplies many times the inhospital mortality risk in unstable angina. 4) Every therapeutic effort should be made to control heart rate / convert atrial fibrillation in unstable angina.



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2nd Virtual Congress of Cardiology

Dr. Florencio Garófalo
Steering Committee
Dr. Raúl Bretal
Scientific Committee
Dr. Armando Pacher
Technical Committee - CETIFAC

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