Baseline characteristics of study population:
A total of 1793 patients were screened for eligibility. Of these, 1626
patients admitted with de novo acute MI were enrolled in this study. The
mean (SD) age of the population was 61.5 (12.5) years and men made up
70.7% of the study population. Fifty-one (3.1%) patients were
diagnosed with AF. Dramatically, the minority of patients were
previously diagnosed with AF (14 patients, 27.4%) and only 1 out of
every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants
(OAC). Demographic and clinical characteristics of the study population
are presented in Table 1. Patients in the AF group were older than the
non-AF group [mean 73.4 (9.4) vs. 61.0 (12.4) years,
p<0.001]. The percentage of women in the AF group was also
higher than that in the non-AF group (43.1% vs. 28.7%, p=0.027).
Non-ST segment elevation MI (NSTEMI) presentation (68.6% vs. 53.2%,
p=0.023) and prevalence of hypertension (64.7% vs. 48.5%, p=0.023)
were more common in patients in the AF group. Conversely, fewer patients
in the AF group smoked than in the non-AF group (39.2% vs. 58.6%,
p=0.006). Median LV ejection fraction at admission was lower in AF
patients than the non-AF patients [45.0% (30-50%) vs. 50.0%
(35-55%), p=0.008]. Hemoglobin levels were also lower in the AF group
[12.7 (2.2) vs. 13.7 (1.9) gr/dL, p=0.004]. A greater number of
patients in the AF group were classified as Killip class 3 and 4 at
admission (3.9% vs. 2.9%, p=0.001). Severe mitral regurgitation was
more common in AF patients (11.7% vs. 1.7%, p<0.001).
Although the STEMI rate was 46.0% for the entire study population, only
3.0% of the total population, none of which were in the AF group,
received thrombolytic treatment as a reperfusion therapy before
diagnostic coronary angiography. Oral P2Y12 inhibitor
loading before the index emergency admission rate was higher in AF
patients (96.0% vs. 91.8%, p=0.027). Clopidogrel was the most commonly
used P2Y12 inhibitor in the study population (49.2%).
On the other hand, the loading rate of oral P2Y12inhibitors other than clopidogrel was 31.3% in the AF and 47.6% in the
non-AF group (p=0.004). Preexisting oral anticoagulant use was also
higher in AF patients (19.6% vs. 1.0%, p<0.001) (Table 2).