Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
Afib May Spark MI
Published: Nov 4, 2013
By Todd Neale, Senior Staff Writer, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania
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Action Points
Afib is independently associated with an increased risk of incident myocardial infarction.
The risk of MI associated with Afib was significantly higher in women and in blacks.
Although myocardial infarction is a known risk factor for the development of atrial fibrillation, the relationship might work the other way around, too, researchers found.
Among patients without a history of coronary heart disease, those with atrial fibrillation were 70% more likely to have an MI through an average of about 7 years of follow-up after accounting for other potential risk factors (HR 1.70, 95% CI 1.26-2.30), according to Elsayed Soliman, MD, of Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues.
That risk was greatest among women (HR 2.16, 95% CI 1.41-3.31) and black individuals (HR 2.53, 95% CI 1.67-3.86), they reported online in JAMA Internal Medicine.
"These data ... add to the growing recognition of important bidirectional relationships between atrial fibrillation and other cardiovascular comorbidities," Jonathan Dukes, MD, and Gregory Marcus, MD, of the University of California San Francisco, wrote in an accompanying editorial. "Just as 'AF begets AF,' we are learning it may also lead to kidney disease, heart failure, and now MI."
The study included 23,928 black and white participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who did not have coronary heart disease at baseline; 6.8% had atrial fibrillation detected either with a study-scheduled ECG or through a reported history of a physician diagnosis.
Through an average of 6.9 years of follow-up, there were 648 incident MIs, with a rate twice as high among the patients with atrial fibrillation (12 versus 6 per 1,000 person-years, P
Published: Nov 4, 2013
By Todd Neale, Senior Staff Writer, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania
save
|
A
A
Action Points
Afib is independently associated with an increased risk of incident myocardial infarction.
The risk of MI associated with Afib was significantly higher in women and in blacks.
Although myocardial infarction is a known risk factor for the development of atrial fibrillation, the relationship might work the other way around, too, researchers found.
Among patients without a history of coronary heart disease, those with atrial fibrillation were 70% more likely to have an MI through an average of about 7 years of follow-up after accounting for other potential risk factors (HR 1.70, 95% CI 1.26-2.30), according to Elsayed Soliman, MD, of Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues.
That risk was greatest among women (HR 2.16, 95% CI 1.41-3.31) and black individuals (HR 2.53, 95% CI 1.67-3.86), they reported online in JAMA Internal Medicine.
"These data ... add to the growing recognition of important bidirectional relationships between atrial fibrillation and other cardiovascular comorbidities," Jonathan Dukes, MD, and Gregory Marcus, MD, of the University of California San Francisco, wrote in an accompanying editorial. "Just as 'AF begets AF,' we are learning it may also lead to kidney disease, heart failure, and now MI."
The study included 23,928 black and white participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who did not have coronary heart disease at baseline; 6.8% had atrial fibrillation detected either with a study-scheduled ECG or through a reported history of a physician diagnosis.
Through an average of 6.9 years of follow-up, there were 648 incident MIs, with a rate twice as high among the patients with atrial fibrillation (12 versus 6 per 1,000 person-years, P
The risk was highest for black men, then black women, then white women, then white men. Essentially, afib didn't raise the heart attack rate for white males.
Also, taking anticoagulants makes the higher risk disappear:
Age did not seem to affect the association, but warfarin use did.
The risk of MI associated with atrial fibrillation was not significantly elevated in warfarin users (HR 0.76, 95% CI 0.29-1.94), but it was in nonusers (HR 1.92, 95% CI 1.42-2.60), which "accords with previous reports showing that warfarin might provide a protective effect against MI after acute coronary syndromes and in patients with atrial fibrillation who are prescribed anticoagulation for stroke prevention," the authors wrote."
If you are wondering, dabigatran reduces MI more than warfarin.
http://www.cardiosource.org/News-Me...
American College of Cardiology
Extract:
However, adjusted mortality was significantly lower with both dabigatran doses when compared to warfarin. Pulmonary embolism was lower compared to warfarin for both doses of dabigatran.
Further, less intracranial bleeding was seen with both dabigatran doses and the incidence of myocardial infarction was lower with both dabigatran doses. Gastrointestinal bleeding was also lower with dabigatran 110mg compared to warfarin, but not dabigatran 150mg BID.
"The previous concerns about an excess of bleeding events or MI amongst dabigatran treated-patients were not evident."
petey
What about a comparison between Warfarin and Xarelto and Eliquis?
I'm fine with Warfarin. I don't mind the dietary restrictions or the blood tests but do think about switching if one of the others really would be that much more beneficial.
At my last appointment my cardiologist sort of recommended Eliquis as his preference.but did add that it hadn't been on the market very long to assess side effects etc.
Annette
First I had to give up many fats due to clogged arteries, then it was reduced farther by diabetes as to what I could eat, then I was put on cumadin which reduced it even farther. Sometimes it seems like the only thing good for us is pills! (and I definitely don't agree with that statement).