Skip to main content
SpringerLink
Log in

Atrial fibrillation increases the risk of new-onset myocardial infarction amongst working-age population: a propensity-matched study

Vorhofflimmern erhöht das Risiko eines neu auftretenden Myokardinfarkts bei der Bevölkerung im erwerbsfähigen Alter: eine Propensity-Matched-Studie

  • Original articles
  • Published:
Herz Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to investigate the association between atrial fibrillation (AF) and new-onset myocardial infarction (MI) among a working-age population in an industrial city of North China.

Methods

In total 77,670 participants aged under 60 years were selected for this cohort study. Participants were divided into an AF group (n = 121) and a non-AF group (n = 74,565) based on their medical histories. Thereafter, 121 participants from the AF group were propensity-matched with 363 participants from the non-AF group. All participants were followed up from June 2006 to December 2020; new-onset MI was regarded as the endpoint of this study. Multivariate Cox proportional hazards regression analysis models were designed to analyze the correlation between AF and new-onset MI.

Results

During the 14-year follow-up, eight cases of new-onset MI were documented in the AF group, while five cases were documented in the non-AF group. The cumulative incidence of new-onset MI in the AF group (7.40%) was markedly higher than in the non-AF group (1.41%; p < 0.001). Atrial fibrillation was associated with an increased risk of new-onset MI in both univariate analysis (hazard ratio: 5.202, 95% confidence interval [CI]: 1.700–15.913) and multivariable-adjusted analysis (hazard ratio: 5.335, 95% CI: 1.683–16.910).

Conclusion

Atrial fibrillation increased the risk of new-onset MI amongst working-age individuals in an industrial city of North China.

Zusammenfassung

Ziel

Ziel dieser Studie war es, den Zusammenhang zwischen Vorhofflimmern (VHF) und neu auftretenden Myokardinfarkten in einer Bevölkerungsgruppe im arbeitsfähigen Alter in einer nordchinesischen Industriestadt zu untersuchen.

Methoden

Für diese Kohortenstudie wurden insgesamt 77.670 Teilnehmer im Alter von unter 60 Jahren ausgewählt. Alle Teilnehmer wurden anhand ihrer Vorerkrankungen in eine VHF-Gruppe (n = 121) und eine Nicht-VHF-Gruppe (n = 74.565) eingeteilt. Anschließend wurden 121 Teilnehmer aus der Gruppe mit Vorhofflimmern mit 363 Teilnehmern aus der Gruppe ohne Vorhofflimmern nach dem Propensity-Score-Matching-Verfahren verglichen. Alle Studienteilnehmer wurden von Juni 2006 bis Dezember 2020 nachbeobachtet, wobei ein neuauftretender Myokardinfarkt als Endpunkt der Studie gewertet wurde. Um den Zusammenhang zwischen Vorhofflimmern und neu auftretenden Myokardinfarkten zu analysieren wurden Cox-Regressionsmodelle genutzt.

Ergebnisse

Während der 14-jährigen Nachbeobachtungszeit traten in der VHF-Gruppe 8 Fälle von neu auftretenden Myokardinfarkten auf, während in der Nicht-VHF-Gruppe 5 Fälle auftraten. Die kumulative Inzidenz in der AF-Gruppe (7,40 %) war signifikant höher als in der Nicht-VHF-Gruppe (1,41 %; p < 0,001). Vorhofflimmern war sowohl in einer univariaten Analyse (Hazard Ratio: 5,202, 95 % Konfidenzintervall [KI]: 1,700-15,913) als auch in einer multivariablen bereinigten Analyse (Hazard Ratio: 5,335, 95 % KI: 1,683-16,910) mit einem erhöhten Risiko für neu auftretenden Myokardinfarkten verbunden.

Schlussfolgerungen

Vorhofflimmern erhöht das Risiko für neu auftretende Myokardinfarkte bei der Bevölkerung im erwerbsfähigen Alter von unter 60 Jahren in einer nordchinesischen Industriestadt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Schnall P, Belkić K, Landsbergis P, Baker D (2000) Why the workplace and cardiovascular disease? Occup Med 15:1–6

    CAS  PubMed  Google Scholar 

  2. Camen S, Csengeri D, Geelhoed B et al (2022) Risk factors, subsequent disease onset, and prognostic impact of myocardial infarction and atrial fibrillation. J Am Heart Assoc 11:e24299

  3. Soliman EZ, Safford MM, Muntner P et al (2014) Atrial fibrillation and the risk of myocardial infarction. JAMA Intern Med 174:107–114

  4. Wu J, Hou Q, Han Q et al (2022) Atrial fibrillation is an independent risk factor for new-onset myocardial infarction: a prospective study. Acta Cardiol. https://doi.org/10.1080/00015385.2022.2129184

    Article  PubMed  Google Scholar 

  5. Shi S, Tang Y, Zhao Q et al (2022) Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study. Lancet Reg Health West Pac 23:100439

    Article  PubMed  PubMed Central  Google Scholar 

  6. Baena CP, Olandoski M, Luhm KR et al (2012) Tendency of mortality in acute myocardial infarction in Curitiba (PR) in the period of 1998 to 2009. Arq Bras Cardiol 98:211–217

    PubMed  Google Scholar 

  7. Fuster V, Rydén LE, Cannom DS et al (2006) ACC/AHA/ESC 2006 Guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the management of patients with atrial fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114:e257–354

    PubMed  Google Scholar 

  8. Antman EM, Anbe DT, Armstrong PW et al (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). Circulation 110:e82–292

    PubMed  Google Scholar 

  9. Anderson JL, Adams CD, Antman EM et al (2007) ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction): developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. Circulation 116:e148–304

    PubMed  Google Scholar 

  10. Wojcik M (2012) Co-existence of atrial fibrillation with myocardial infarction—Unhealthy combination. J Atr Fibrillation 5:666

    PubMed  PubMed Central  Google Scholar 

  11. Iwasaki YK, Nishida K, Kato T, Nattel S (2011) Atrial fibrillation pathophysiology: implications for management. Circulation 124:2264–2274

    Article  CAS  PubMed  Google Scholar 

  12. Willeit K, Kiechl S (2014) Atherosclerosis and atrial fibrillation—two closely intertwined diseases. Atherosclerosis 233:679–681

    Article  CAS  PubMed  Google Scholar 

  13. Watson T, Shantsila E, Lip GY (2009) Mechanisms of thrombogenesis in atrial fibrillation: Virchow’s triad revisited. Lancet 373:155–166

    Article  CAS  PubMed  Google Scholar 

  14. Bhatia GS, Lip GY (2004) Atrial fibrillation post-myocardial infarction: frequency, consequences, and management. Curr Heart Fail Rep 1:149–155

    Article  PubMed  Google Scholar 

  15. Congo KH, Belo A, Carvalho J et al (2019) New-onset atrial fibrillation in st-segment elevation myocardial infarction: predictors and impact on therapy and mortality. Arq Bras Cardiol 113:948–957

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Batra G, Svennblad B, Held C et al (2016) All types of atrial fibrillation in the setting of myocardial infarction are associated with impaired outcome. Heart 102:926–933

    Article  CAS  PubMed  Google Scholar 

  17. Jons C, Jacobsen UG, Joergensen RM et al (2011) The incidence and prognostic significance of new-onset atrial fibrillation in patients with acute myocardial infarction and left ventricular systolic dysfunction: a CARISMA substudy. Heart Rhythm 8:342–348

    Article  PubMed  Google Scholar 

  18. Shiyovich A, Axelrod M, Gilutz H, Plakht Y (2019) Early versus late new-onset atrial fibrillation in acute myocardial infarction: differences in clinical characteristics and predictors. Angiology 70:921–928

    Article  PubMed  Google Scholar 

  19. Galvão Braga C, Ramos V, Vieira C et al (2014) New-onset atrial fibrillation during acute coronary syndromes: predictors and prognosis. Rev Port Cardiol 33:281–287

    Article  PubMed  Google Scholar 

  20. Bang CN, Gislason GH, Greve AM et al (2014) New-onset atrial fibrillation is associated with cardiovascular events leading to death in a first time myocardial infarction population of 89,703 patients with long-term follow-up: a nationwide study. J Am Heart Assoc 3:e382

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wolf PA, Mitchell JB, Baker CS et al (1998) Impact of atria lfibrillation on mortality, stroke, and medical costs. Arch Intern Med 158:229–234

    Article  CAS  PubMed  Google Scholar 

  22. Soliman EZ, Lopez F, O’Neal WT et al (2015) Atrial fibrillation and risk of ST segment-elevation versus non-ST-segment-elevation myocardial infarction: the atherosclerosis risk in communities (ARIC) study. Circulation 131:1843–1850

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lee HY, Yang PS, Kim TH et al (2017) Atrial fibrillation and the risk of myocardial infarction: a nation-wide propensity matched study. SciRep 7:12716

    Google Scholar 

  24. Naccarelli GV, Johnston SS, Dalal M et al (2012) Rates and implications for hospitalization of patients ≥65 years of age with atrial fibrillation/flutter. Am J Cardiol 109:543–549

    Article  PubMed  Google Scholar 

  25. Bayturan O, Puri R, Tuzcu EM et al (2017) Atrial fibrillation, progression of coronary atherosclerosis and myocardial infarction. Eur J Prev Cardiol 24:373–381

    Article  PubMed  Google Scholar 

  26. O’Neal WT, Sangal K, Zhang ZM, Soliman EZ (2014) Atrial fibrillation and incident myocardial infarction in the elderly. Clin Cardiol 37:750–755

    Article  PubMed  PubMed Central  Google Scholar 

  27. Cooney MT, Vartiainen E, Laatikainen T et al (2012) Cardiovascular risk age: concepts and practicalities. Heart 98:941–946

    Article  PubMed  Google Scholar 

  28. Deng H, Guo P, Zheng M et al (2018) Epidemiological characteristics of atrial fibrillation in southern China: results from the Guangzhou heart study. Sci Rep 8:17829

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Xing L, Lin M, Du Z et al (2020) Epidemiology of atrial fibrillation in northeast China: a cross-sectional study, 2017––2019. Heart 106:590–595

    Article  PubMed  Google Scholar 

  30. Yonezawa Y, Horinaka S, Shirakawa C, Kogure Y (2018) Estimated glomerular filtration ratio is a better index than creatinine clearance (Cockcroft-Gault) for predicting the prevalence of atrial fibrillation in the general Japanese population. Hypertens Res 41:451–459

    Article  PubMed  Google Scholar 

  31. Lee SR, Choi EK, Han K et al (2018) Prevalence of non-valvular atrial fibrillation based on geographical distribution and socioeconomic status in the entire Korean population. Korean Circ J 48:622–634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by the Key Scientific Research Project (No. 20221777), Health Commission of Hebei Province, P.R. China.

Author information

Authors and Affiliations

  1. Department of Cardiology, Tangshan Gongren Hospital, NO.27, Wenhua Road, 063000, Tangshan, Lubei District, China

    Bocheng Yue, Quanle Han MD & Boheng Zhang

  2. Hebei Medical University, Shijiazhuang, China

    Qiqi Hou & Quanle Han MD

  3. Brandenburg Medical School Theodor Fontane, Neuruppin, Germany

    Julian Bredehorst

  4. Catheterization Unit, Tangshan Gongren Hospital, Tangshan, China

    Chao Zhang

  5. Department of Rehabilitation Medicine, Kailuan Tangjiazhuang Hospital, Tangshan, China

    Jiawei Zhang

  6. Department of Cardiology, Kailuan General Hospital, Tangshan, China

    Shuohua Chen & Shouling Wu MD

  7. School of Clinical Medicine, North China University of Science and Technology, Tangshan, China

    Quanle Han MD & Kangbo Li MD PhD

Authors
  1. Bocheng Yue
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qiqi Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julian Bredehorst
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Quanle Han MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Boheng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jiawei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shuohua Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shouling Wu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kangbo Li MD PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Quanle Han, Shouling Wu and Kangbo Li contributed equally to designing and monitoring the study. All authors contributed to drafting and approving the manuscript.

Corresponding author

Correspondence to Quanle Han MD.

Ethics declarations

Conflict of interest

B. Yue, Q. Hou, J. Bredehorst, Q. Han, B. Zhang, C. Zhang, J. Zhang, S. Chen, S. Wu and K. Li declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yue, B., Hou, Q., Bredehorst, J. et al. Atrial fibrillation increases the risk of new-onset myocardial infarction amongst working-age population: a propensity-matched study. Herz 48, 408–412 (2023). https://doi.org/10.1007/s00059-023-05181-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00059-023-05181-7

Keywords

Schlüsselwörter

Search

Navigation