Background: The purpose of this study was to assess the association between new onset of
atrial fibrillation (AF) and in-hospital management and mortality in acute coronary syndrome
patients admitted to hospitals without on-site invasive facilities.
Methods: We assessed data concerning in-hospital management and mortality of 24 patients
with, and 977 patients without, new onset of AF from the Krakow Registry of Acute Coronary
Syndromes database.
Results: Patients with new onset of AF were older and more likely to have diabetes, chronic
obstructive pulmonary disease, cardiogenic shock and chest pain on admission, and a shorter
time from the onset of symptoms to admission. These patients more frequently received glycoprotein
IIb/IIIa inhibitors, thrombolytics, and were less likely to be treated with statins during
their hospital stay. Risk of AF occurrence was lower in patients treated with statins (1.9% vs
5.2%; p = 0.021). Among patients treated conservatively, in-hospital mortality was higher in
patients with new onset of AF (8.1% vs 33.3%; p = 0.001). Independent predictors of inhospital
death in this group of patients were: new onset of AF, age, cardiogenic shock, chronic
obstructive pulmonary disease, history of renal insufficiency, and discharge diagnosis.
Conclusions: New onset of AF is associated with excessive in-hospital mortality in acute
coronary syndrome patients staying on conservative treatment in community hospitals without
on-site invasive facilities. (Cardiol J 2010; 17, 1: 57-64
