Hyperglycemia increases new-onset atrial fibrillation in patients with acute ST-elevation myocardial infarction

Background: Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction, and is often accompanied by an increased morbidity and mortality. The aim of this study was to investigate the predictors and outcome of new-onset AF occurring after acute ST-elevation myocardial infarction (STEMI). Methods: A total of 307 patients with acute STEMI from May 2007 to June 2009 were included in our study. Of those patients, 57 patients experienced new-onset AF during their hospitalization in the coronary care unit with continuous ECG monitoring. The primary endpoint was the occurrence of AF during the hospitalization. The secondary endpoint was the all-cause mortality during a 12-month follow-up period. Results: Two hundred eighty three patients (92.2%) received revascularization during the hospitalization. The patients with new-onset AF after the acute STEMI were older, with lower diastolic blood pressure, higher initial fasting glucose, lower lipid level, and a higher incidence of coronary artery disease history when compared to those without new-onset AF. In a multivariable analysis, the initial fasting glucose level (p = 0.025, OR = 1.007, 95% CI = 1.001∼1.012) was an independent predictor of the occurrence of new-onset AF after acute STEMI. New-onset AF was associated with a higher all-cause mortality rate during the follow-up (p = 0.001). Conclusion: Ahigher initial fasting glucose level was an independent predictor of the occurrence of AF in patients with acute STEMI, which may be associated with a poor prognosis.