Association between Atrial Fibrillation and Mortality after Percutaneous Coronary Intervention

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Patients with coronary artery disease and atrial fibrillation (AF) are at high risk of stroke, bleeding and heart failure. The aim of the present study was to assess association between AF and mortality in patients who underwent percutaneous coronary intervention (PCI). Methods: Consecutive patients who underwent PCI from 2007 to 2009 in two cardiovascular centers were enrolled in the present study. Results: Of 963 patients (69±10 years, male 75%), 92 patients (10%) had AF and 73 patients (8%) died during a median follow-up period of 619 days. Warfarin was administered in 113 patients (12%), of whom 75 patients had AF (82% of the AF patients). Mortality rate over 2-years in patients with AF and sinus rhythm were 17.9% and 7.5%, respectively (p=0.0012). Rate of major bleeding over 2-years was similar between patients with AF and sinus rhythm (4.0% vs. 3.9%, p=0.9), while rate of stroke over 2-years was higher in patients with AF compared with those with sinus rhythm (6.0% vs. 1.6%, p=0.018). In a multivariate model, age (HR: 1.06 [95%CI: 1.03–1.11], p=0.001), left ventricular ejection fraction (HR: 0.96 [0.94–0.98], p<0.001), AF (HR: 5.45 [1.89–15.67], p=0.002) and hemoglobin level (HR: 0.78 [0.68–0.88], p<0.001) were associated with mortality. Conclusion: In patients who underwent PCI, AF was associated with 5-fold increased risk of mortality.