Prognostic impact of atrial fibrillation in cardiogenic shock complicating acute myocardial infarction: a substudy of the IABP-SHOCK II trial

Clin Res Cardiol. 2018 Mar;107(3):233-240. doi: 10.1007/s00392-017-1175-1. Epub 2017 Nov 10.

Abstract

Background: Aim of the current study was to analyse the impact of atrial fibrillation (AF) on prognosis in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI), which has never been investigated yet.

Methods: The current analysis is a substudy of the IABP-SHOCK II trial. Patients were grouped according to the presence or absence of AF. The primary endpoint was all-cause mortality at 30-day follow-up. Secondary endpoints included all-cause mortality, recurrent myocardial infarction, repeat revascularisation, and stroke at 12 months.

Results: AF was documented in 28.2% (n = 169) of all 600 patients initially enrolled in the IABP-SHOCK II trial. There were no significant differences with respect to mortality at 30 days and 12 months between patients with and without AF (p = 0.81, p = 0.74). Similarly, the rates of recurrent myocardial infarction, repeat revascularisation, and stroke did not differ between groups (all p > 0.05). There was no interaction of intraaortic balloon counterpulsation (IABP) and no IABP in patients with or without AF with respect to clinical outcome at 30 days and 12 months (p > 0.05).

Conclusion: AF is not associated with clinical outcome at 30 days and 12 months in CS complicating AMI.

Keywords: Acute myocardial infarction; Atrial fibrillation; Cardiogenic shock; Prognosis.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / mortality
  • Cause of Death / trends
  • Coronary Angiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Incidence
  • Intra-Aortic Balloon Pumping
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / surgery
  • Percutaneous Coronary Intervention
  • Prognosis
  • Prospective Studies
  • Shock, Cardiogenic / complications*
  • Shock, Cardiogenic / epidemiology
  • Shock, Cardiogenic / therapy
  • Survival Rate / trends