Acute myocardial infarction in patients with atrial fibrillation with a CHA2DS2-VASc score of 0 or 1: A nationwide cohort study

Tze Fan Chao; Yen Chang Huang; Chia Jen Liu; Su Jung Chen; Kang Ling Wang; Yenn Jiang Lin; Shih Lin Chang; Li Wei Lo; Yu Feng Hu; Ta Chuan Tuan; Tzeng Ji Chen; Ming Hsiung Hsieh; Gregory Y.H. Lip; Shih Ann Chen

doi:10.1016/j.hrthm.2014.08.003

Acute myocardial infarction in patients with atrial fibrillation with a CHA₂DS₂-VASc score of 0 or 1: A nationwide cohort study

Tze Fan Chao, Yen Chang Huang, Chia Jen Liu, Su Jung Chen, Kang Ling Wang, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Tzeng Ji Chen, Ming Hsiung Hsieh, Gregory Y.H. Lip, Shih Ann Chen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background The risk of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF) with a CHA₂DS₂-VASc score of 0 (for men) or 1 (for women) has not been previously investigated. Objective The objective of the present study was to compare the risk of AMI in AF and non-AF subjects with a low (0 or 1) CHA₂DS₂-VASc score. Methods By using the National Health Insurance Research Database in Taiwan, we identified 7254 men with AF (with a CHA₂DS₂-VASc score of 0) and 4860 women with AF (with a CHA₂DS₂-VASc score of 1). For each study patient, 1 age-, sex-, and CHA₂DS₂-VASc score–matched subject without AF was randomly selected to constitute the control group (n = 12,114). The clinical end point was the occurrence of AMI. Results During a mean follow-up period of 5.7 ± 3.6 years, 258 patients (1.1%) suffered an AMI, with an annual incidence of 0.29% and 0.10% for patients with and without AF. AF was an independent risk factor of AMI, with an adjusted hazard ratio (HR) of 2.93 (95% confidence interval 2.21–3.87; P <.001). The risk of AMI was higher in men with AF than in women with AF, with a hazard ratio of 2.24 (95% confidence interval 1.61–3.11; P <.001) after adjustment for age and other comorbidities. Conclusion In patients with a CHA₂DS₂-VASc score of 0 or 1, AF was an independent risk factor of AMI. The risk of AMI was higher in men with AF than in women with AF. Cardiovascular risk prevention should be performed as part of the holistic management of AF to minimize the risks of AMI associated with AF.

Original language	English
Pages (from-to)	1941-1947
Number of pages	7
Journal	Heart Rhythm
Volume	11
Issue number	11
DOIs	https://doi.org/10.1016/j.hrthm.2014.08.003
State	Published - Nov 2014

Keywords

Atrial fibrillation
CHADS-VASc score
Gender
Myocardial infarction
Subclinical atherosclerosis

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Chao, T. F., Huang, Y. C., Liu, C. J., Chen, S. J., Wang, K. L., Lin, Y. J., Chang, S. L., Lo, L. W., Hu, Y. F., Tuan, T. C., Chen, T. J., Hsieh, M. H., Lip, G. Y. H., & Chen, S. A. (2014). Acute myocardial infarction in patients with atrial fibrillation with a CHA₂DS₂-VASc score of 0 or 1: A nationwide cohort study. Heart Rhythm, 11(11), 1941-1947. https://doi.org/10.1016/j.hrthm.2014.08.003

@article{e48347f4bda841af846b783c560570d8,

title = "Acute myocardial infarction in patients with atrial fibrillation with a CHA2DS2-VASc score of 0 or 1: A nationwide cohort study",

abstract = "Background The risk of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF) with a CHA2DS2-VASc score of 0 (for men) or 1 (for women) has not been previously investigated. Objective The objective of the present study was to compare the risk of AMI in AF and non-AF subjects with a low (0 or 1) CHA2DS2-VASc score. Methods By using the National Health Insurance Research Database in Taiwan, we identified 7254 men with AF (with a CHA2DS2-VASc score of 0) and 4860 women with AF (with a CHA2DS2-VASc score of 1). For each study patient, 1 age-, sex-, and CHA2DS2-VASc score–matched subject without AF was randomly selected to constitute the control group (n = 12,114). The clinical end point was the occurrence of AMI. Results During a mean follow-up period of 5.7 ± 3.6 years, 258 patients (1.1%) suffered an AMI, with an annual incidence of 0.29% and 0.10% for patients with and without AF. AF was an independent risk factor of AMI, with an adjusted hazard ratio (HR) of 2.93 (95% confidence interval 2.21–3.87; P <.001). The risk of AMI was higher in men with AF than in women with AF, with a hazard ratio of 2.24 (95% confidence interval 1.61–3.11; P <.001) after adjustment for age and other comorbidities. Conclusion In patients with a CHA2DS2-VASc score of 0 or 1, AF was an independent risk factor of AMI. The risk of AMI was higher in men with AF than in women with AF. Cardiovascular risk prevention should be performed as part of the holistic management of AF to minimize the risks of AMI associated with AF.",

keywords = "Atrial fibrillation, CHADS-VASc score, Gender, Myocardial infarction, Subclinical atherosclerosis",

author = "Chao, {Tze Fan} and Huang, {Yen Chang} and Liu, {Chia Jen} and Chen, {Su Jung} and Wang, {Kang Ling} and Lin, {Yenn Jiang} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Tuan, {Ta Chuan} and Chen, {Tzeng Ji} and Hsieh, {Ming Hsiung} and Lip, {Gregory Y.H.} and Chen, {Shih Ann}",

note = "Publisher Copyright: {\textcopyright} 2014 Heart Rhythm Society",

year = "2014",

month = nov,

doi = "10.1016/j.hrthm.2014.08.003",

language = "English",

volume = "11",

pages = "1941--1947",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier B.V.",

number = "11",

}

TY - JOUR

T1 - Acute myocardial infarction in patients with atrial fibrillation with a CHA2DS2-VASc score of 0 or 1

T2 - A nationwide cohort study

AU - Chao, Tze Fan

AU - Huang, Yen Chang

AU - Liu, Chia Jen

AU - Chen, Su Jung

AU - Wang, Kang Ling

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Tuan, Ta Chuan

AU - Chen, Tzeng Ji

AU - Hsieh, Ming Hsiung

AU - Lip, Gregory Y.H.

AU - Chen, Shih Ann

PY - 2014/11

Y1 - 2014/11

N2 - Background The risk of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF) with a CHA2DS2-VASc score of 0 (for men) or 1 (for women) has not been previously investigated. Objective The objective of the present study was to compare the risk of AMI in AF and non-AF subjects with a low (0 or 1) CHA2DS2-VASc score. Methods By using the National Health Insurance Research Database in Taiwan, we identified 7254 men with AF (with a CHA2DS2-VASc score of 0) and 4860 women with AF (with a CHA2DS2-VASc score of 1). For each study patient, 1 age-, sex-, and CHA2DS2-VASc score–matched subject without AF was randomly selected to constitute the control group (n = 12,114). The clinical end point was the occurrence of AMI. Results During a mean follow-up period of 5.7 ± 3.6 years, 258 patients (1.1%) suffered an AMI, with an annual incidence of 0.29% and 0.10% for patients with and without AF. AF was an independent risk factor of AMI, with an adjusted hazard ratio (HR) of 2.93 (95% confidence interval 2.21–3.87; P <.001). The risk of AMI was higher in men with AF than in women with AF, with a hazard ratio of 2.24 (95% confidence interval 1.61–3.11; P <.001) after adjustment for age and other comorbidities. Conclusion In patients with a CHA2DS2-VASc score of 0 or 1, AF was an independent risk factor of AMI. The risk of AMI was higher in men with AF than in women with AF. Cardiovascular risk prevention should be performed as part of the holistic management of AF to minimize the risks of AMI associated with AF.

AB - Background The risk of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF) with a CHA2DS2-VASc score of 0 (for men) or 1 (for women) has not been previously investigated. Objective The objective of the present study was to compare the risk of AMI in AF and non-AF subjects with a low (0 or 1) CHA2DS2-VASc score. Methods By using the National Health Insurance Research Database in Taiwan, we identified 7254 men with AF (with a CHA2DS2-VASc score of 0) and 4860 women with AF (with a CHA2DS2-VASc score of 1). For each study patient, 1 age-, sex-, and CHA2DS2-VASc score–matched subject without AF was randomly selected to constitute the control group (n = 12,114). The clinical end point was the occurrence of AMI. Results During a mean follow-up period of 5.7 ± 3.6 years, 258 patients (1.1%) suffered an AMI, with an annual incidence of 0.29% and 0.10% for patients with and without AF. AF was an independent risk factor of AMI, with an adjusted hazard ratio (HR) of 2.93 (95% confidence interval 2.21–3.87; P <.001). The risk of AMI was higher in men with AF than in women with AF, with a hazard ratio of 2.24 (95% confidence interval 1.61–3.11; P <.001) after adjustment for age and other comorbidities. Conclusion In patients with a CHA2DS2-VASc score of 0 or 1, AF was an independent risk factor of AMI. The risk of AMI was higher in men with AF than in women with AF. Cardiovascular risk prevention should be performed as part of the holistic management of AF to minimize the risks of AMI associated with AF.

KW - Atrial fibrillation

KW - CHADS-VASc score

KW - Gender

KW - Myocardial infarction

KW - Subclinical atherosclerosis

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SN - 1547-5271

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EP - 1947

JO - Heart Rhythm

JF - Heart Rhythm

IS - 11

ER -

Acute myocardial infarction in patients with atrial fibrillation with a CHA₂DS₂-VASc score of 0 or 1: A nationwide cohort study

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