Articles Tập 67 Số CĐ15 25/09/2026

CLINICAL CHARACTERISTICS, LABORATORY FINDINGS AND 30-DAY CARDIOVASCULAR EVENTS IN PATIENTS WITH ACUTE CORONARY SYNDROME COMPLICATED BY ATRIAL FIBRILLATION

Le Thanh Nam, Phan Tuan Dat, Pham Tran Linh
DOI: 10.52163/yhc.v67i9.6666
12 Views
0 Downloads
Abstract

Atrial fibrillation is a common arrhythmia in patients with acute coronary syndrome and is associated with an increased risk of heart failure, stroke, and short-term mortality. Combining coronary revascularization with anticoagulation for thromboembolic prevention in this population remains clinically challenging, while data on this patient group in Vietnam are still limited.

Objective: To characterize the clinical and paraclinical profiles and evaluate 30-day cardiovascular outcomes in patients with acute coronary syndrome (ACS) complicated by atrial fibrillation (AF) at Hanoi Heart Hospital.

Methods: An ambispective (retrospective–prospective) cohort study was conducted on 63 patients with acute coronary syndrome (ACS) and atrial fibrillation (AF), including patients with newly diagnosed AF and those with a prior history of AF, who were hospitalized at Hanoi Heart Hospital between April 2025 and May 2026. Data were collected from medical records and through follow-up assessments up to 30 days after hospital discharge.

Results: The mean age of the study population was 72.3 ± 11.0 years. The most common comorbidities were hypertension (69.8%) and a history of heart failure (52.4%). The mean CHA₂DS₂-VA score was 3.84 ± 1.22, with 98.4% of patients classified as high thromboembolic risk (≥ 2 points). New-onset atrial fibrillation (NOAF) predominated, accounting for 77.8% of cases, and was mainly detected after hospital admission. Acute heart failure was the most frequent in-hospital event (65.1%). The composite in-hospital event rate was 66.7%, whereas the composite post-discharge cardiovascular event rate through day 30 was markedly lower at 6.3%. At 30 days, 76.2% of patients maintained sinus rhythm, and 77.8% remained on anticoagulant therapy.

Conclusion: Patients with ACS and AF are typically elderly, with multiple comorbidities and high thromboembolic risk. AF was frequently accompanied by a high incidence of acute heart failure and short-term cardiovascular events in this cohort. These findings underscore the necessity of rigorous monitoring and optimized anticoagulant management post-discharge.

 

Keywords
acute coronary syndrome; atrial fibrillation; new-onset atrial fibrillation; cardiovascular events; anticoagulation
References
[1]
1.González-Pacheco H, Márquez MF, Arias-Mendoza A, et al. Clinical features and in-hospital mortality associated with different types of atrial fibrillation in patients with acute coronary syndrome with and without ST elevation. Journal of Cardiology. 2015;66(2):148-154. doi:10.1016/j.jjcc.2015.01.013. Google Scholar
[2]
2.Salerno N, Ielapi J, Cersosimo A, et al. Incidence and outcomes of transient new-onset atrial fibrillation complicating acute coronary syndromes: results from a systematic review and meta-analysis. European Heart Journal Cardiovascular Pharmacotherapy. 2024;10(8):652-661. doi:10.1093/ehjcvp/pvae066. Google Scholar
[3]
3.Wong CK, White HD, Wilcox RG, Criger DA, Califf RM, Topol EJ, Ohman EM. New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. American Heart Journal. 2000;140(6):878-885. doi:10.1067/mhj.2000.111108. Google Scholar
[4]
4.Mrdovic I, Savic L, Krljanac G, et al. Incidence, predictors, and 30-day outcomes of new-onset atrial fibrillation after primary percutaneous coronary intervention: insight into the RISK-PCI trial. Coronary Artery Disease. 2012;23(1):1-8. doi:10.1097/MCA.0b013e32834df552. Google Scholar
[5]
5.Obayashi Y, Shiomi H, Morimoto T, et al; CREDO-Kyoto AMI Registry Wave-2 Investigators. Newly diagnosed atrial fibrillation in acute myocardial infarction. Journal of the American Heart Association. 2021;10(18):e021417. doi:10.1161/JAHA.121.021417. Google Scholar
[6]
6.Lopes RD, Pieper KS, Horton JR, et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart. 2008;94(7):867-873. doi:10.1136/hrt.2007.134486. Google Scholar
[7]
7. Narasimhan B, Patel N, Chakraborty S, et al. Impact of Atrial Fibrillation on Acute Coronary Syndrome — Analysis of In-Hospital Outcomes and 30-Day Readmissions. Curr Probl Cardiol. 2021;46(4):100764. doi:10.1016/j.cpcardiol.2020.100764 Google Scholar
[8]
8. Wu N, Li J, Xu X, et al. Prediction Model of New Onset Atrial Fibrillation in Patients with Acute Coronary Syndrome. Int J Clin Pract. 2023;2023:3473603. doi:10.1155/2023/3473603 Google Scholar
[9]
9. Fauchier L, Bisson A, Bodin A, et al. Outcomes in patients with acute myocardial infarction and new atrial fibrillation: a nationwide analysis. Clin Res Cardiol. 2021;110(9):1431–1438. doi:10.1007/s00392-021-01805-2 Google Scholar