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Title: Adverse long-term clinical outcomes among patients with pre-procedural atrial fibrillation undergoing percutaneous coronary intervention.
Author: Batchelor, R.
Dinh, D.
Brennan, A.
Noaman, S.
Clark, D.
Ajani, A.
Oqueli, Ernesto
Yip, T.
Freeman, M.
Stub, D.
Reid, C.
Duffy, S.
Chan, W.
Issue Date: 2020
Conference Name: 68th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 14th Annual Australia and New Zealand Endovascular Therapies Meeting
Conference Date: December 11-13
Conference Place: Online
Abstract: Background: Approximately 5-10% of patients presenting for percutaneous coronary intervention (PCI) have concurrent atrial fibrillation (AF). To what extent AF portends adverse long-term outcomes in these patients remains to be defined. Methods: We analysed data from the multicentre Melbourne Interventional Group Registry from 2008-2018. Patients were identified as being in AF or sinus rhythm (SR) at the commencement of PCI. The primary endpoint was long-term mortality, obtained via linkage with the National Death Index. Multivariate logistic regression was used to compare predictors of long-term mortality. Results: 26,208 procedures were included, with 1,485 (5.7%) patients in AF and 24723 (94.3%) in SR. Compared to SR, patients with AF were older (73.3±10.4 vs 64.0±12.0, p<0.001), more likely to be female (26.8% vs 23%, p=0.001), have diabetes (31.3% vs 25.0%, p<0.001), and left ventricular systolic dysfunction (38.5% vs 21.3%, p<0.001). AF was associated with an increased risk of in-hospital mortality (9.8% vs 2.1%, p<0.001) and MACE (composite of all-cause mortality, myocardial infarction or target vessel revascularisation) (10.7% vs 3.8%, p<0.001). In-hospital major bleeding was more common in the AF group (3.3% vs 1.0%, p<0.001). AF was an independent predictor of long-term mortality (adjusted HR 1.59, 95% CI 1.42–1.78, p<0.001) and was a stronger correlate than age (HR 1.07, 95% CI 1.06–1.07, p<0.001) and cerebrovascular disease (1.27, 95% CI 1.33–1.43, p<0.001). Conclusions: Patients with preprocedural AF represent a high-risk group of patients. When adjusted for other adverse predictors, preprocedural AF was associated with a 1.6 fold increase risk in long-term mortality.
Internal ID Number: 01647
Type: Conference
Appears in Collections:Research Output

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