Rapid Communication - Annals of Cardiovascular and Thoracic Surgery (2022) Volume 5, Issue 3
Administration procedures and results of Intense Coronary Disorder (ACS) in patients with atrial fibrillationElena Arbelo*
Department of Medical Science, Uppsala University, Uppsala, Sweden
- *Corresponding Author:
- Elena Arbelo
Department of Medical Science
Uppsala University, Uppsala, Sweden
E-mail: [email protected]
Received: 27-Apr-2022, Manuscript No. AAACTS-22-112; Editor assigned: 29-Apr-2022, PreQC No. AACTS-22-112 (PQ); Reviewed: 13-May-2022, QC No AAACTS-22-112; Revised: 17-May-2022, Manuscript No. AAACTS-22-112(R); Published: 24-May-2022, DOI:10.35841/aaacts-5.3.112
Citation: Arbelo E. Administration procedures and results of Intense Coronary Disorder (ACS) in patients with atrial fibrillation. Ann Cardiothorac Surg. 2022;5(3):112
Atrial fibrillation (AF) is a common cardiac arrhythmia occurring in an estimated 2.7 to 6.1 million people in the United States. The risk factors for the development of AF are very similar to those for developing coronary artery disease, and AF is often associated with Acute Coronary Syndrome (ACS) and acute Myocardial Infarction (MI) Anticoagulation is usually required both for the treatment of MI, as well as for cerebral vascular accident prevention from AF-induced thromboembolism. Often patients require triple-therapy for optimal treatment of both conditions, and special considerations for bleeding risk must be analyzed. Acute coronary syndrome is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. Acute coronary syndrome often causes severe chest pain or discomfort. It is a medical emergency that requires prompt diagnosis and care. The goals of treatment include improving blood flow, treating complications and preventing future problems.
Atrial fibrillation, Acute coronary syndrome, Mortality.
Atrial fibrillation (AF) is a common cardiac arrhythmia occurring in an estimated 2.7 to 6.1 million people in the United States (US). AF prevalence increases with age affecting 6% of the US population ≥ age 65 . By age 40, the lifetime risk of AF for females and males is 23% and 26% respectively. European statistics are comparable such that an estimated 5.5% of persons above the age 55 have AF with a lifetime risk of 22-24%.
Given the high burden of the arrhythmia, AF accounts for many annual hospitalizations. In fact, the rates of AF admissions increased 34% from 1996 to 2001 in the US . More recently, a study that reviewed all hospital admissions in Australia found that there was a greater than 200% increase in hospitalizations due to AF between 1993 and 2008 representing an annual rise of 8.3%. A review of the data from US healthcare claims from 2004 through 2006 found that the 12 month direct cost for a patient with AF was $20,670 compared to $11,965 for a patient with a similar co-morbidity profi le without AF. With an incremental cost of $8705, inpatient services were the most important cause of the cost difference followed by office then emergency department visits. The acute coronary syndrome is a potent risk factor for atrial fibrillation, with atrial fibrillation occurring in up to 1 in every 5 patients hospitalized with an acute coronary syndrome .
To date, most investigations into the magnitude and impact of atrial fibrillation in the setting of an acute coronary syndrome have been limited by modest sample sizes, short duration of follow-up, and/or inclusion of less generalizable patient populations. Perhaps due to the heterogeneous nature of these investigations, there remains a lack of consensus as to whether or not, independent of underlying risk factors, the development of atrial fibrillation confers an increased risk of dying in patients with an acute coronary syndrome. Moreover, since studies have focused largely on patients who develop new-onset atrial fibrillation during hospitalization for an acute coronary syndrome,13–15 the impact of pre-existing atrial fibrillation on prognosis in this setting is poorly defined .
In this large multinational study, atrial fibrillation was a common and serious complication in patients hospitalized with an acute coronary syndrome, and it is one of the most common heart rhythm disorders, with a prevalence that is only increasing. Risk factors for the development of AF are very similar to those for developing coronary artery disease, so it is no surprise that AF is often associated with acute coronary syndrome and acute MI. It is rare for AF to be the only symptoms of otherwise unrecognized CAD, and routine coronary screening is often unnecessary. However, it is common for AF to be triggered by MI, and the immediate and chronic prognosis in the post-MI setting is worse in patients with AF .
Efforts remain warranted to improve the primary and secondary prevention of all patients hospitalized with an acute coronary syndrome, but particularly among those with pre-existing atrial fibrillation and groups identified in this study as being at high risk for new-onset atrial fibrillation.
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