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01.04.2013 | Original Paper

Prognosis of patients with atrial fibrillation undergoing percutaneous coronary intervention receiving drug eluting stents

verfasst von: Peter Bramlage, Alessandro Cuneo, Uwe Zeymer, Matthias Hochadel, Gert Richardt, Sigmund Silber, Jochen Senges, Christoph A. Nienaber, Ulrich Tebbe, Karl-Heinz Kuck

Erschienen in: Clinical Research in Cardiology | Ausgabe 4/2013

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Abstract

Background

Atrial fibrillation (AF) is increasingly prevalent in elderly patients and adversely affects clinical outcomes after coronary artery bypass grafting, non-cardiac surgery or myocardial infarction. Aim of the present analysis was to investigate the prognostic impact of AF in patients undergoing drug eluting stent (DES) implantation during a 1-year follow-up.

Patients and methods

5,772 consecutive patients undergoing percutaneous coronary intervention were enrolled into the German Drug Eluting Stent Registry (DES.DE) and were followed for 12 months. Of these 455 had AF and 5,317 in sinus rhythm served as controls. Univariate and multivariate logistic regression analyses were used to determine the risk of major adverse cardiac and cerebrovascular events (MACCE) and bleeding complications.

Results

Patients with AF were older (71.3 ± 7.6 vs. 64.7 ± 10.5 years) and had a higher prevalence of diabetes, hypertension, renal insufficiency as well as more prior bypass surgery, stroke and peripheral arterial disease. Cardiogenic shock (2.9 vs. 1.4 %; p < 0.05), left ventricular ejection fraction ≤40 % (21.0 vs. 11.4 %; p < 0.0001) and triple vessel disease (44.4 vs. 37.9 %; p < 0.01) were more frequent in patients with AF than in controls. MACCE (OR 2.08, 95 % CI 1.56–2.77), total mortality (OR 3.27, 95 % CI 2.32–4.62) and non-fatal stroke (OR 2.03, 95 % CI 1.03–4.00) as well as bleeding complications (OR 1.88, 95 % CI 1.13–3.12) during the 1-year follow-up were more frequent in patients with AF (univariate analysis). In multivariate analyses adjusting for covariates determined to be relevant at baseline, the risk for total mortality remained elevated (OR 1.63, 95 % CI 1.05–2.52).

Conclusions

AF is an important predictor of long-term mortality in patients undergoing DES implantation.

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Titel: Prognosis of patients with atrial fibrillation undergoing percutaneous coronary intervention receiving drug eluting stents
verfasst von: Peter Bramlage
Alessandro Cuneo
Uwe Zeymer
Matthias Hochadel
Gert Richardt
Sigmund Silber
Jochen Senges
Christoph A. Nienaber
Ulrich Tebbe
Karl-Heinz Kuck
Publikationsdatum: 01.04.2013
Verlag: Springer-Verlag
Erschienen in: Clinical Research in Cardiology / Ausgabe 4/2013
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-012-0533-2

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