Atrial Fibrillation Increases Risk of Heart Attack

Elsayed Z Soliman MD, MSc, MS, FAHA, FACC Director, Epidemiological Cardiology Research Center (EPICARE) Wake Forest School of Medicine Medical Center Blvs, Winston Salem, NC 27157 MedicalResearch.com Interview with:
Elsayed Z Soliman MD, MSc, MS, FAHA, FACC
Director, Epidemiological Cardiology Research Center (EPICARE)
Wake Forest School of Medicine
Medical Center Blvs, Winston Salem, NC 27157
Atrial Fibrillation and the Risk of Myocardial Infarction

MedicalResearch.com: What are the main findings of the study?

Dr. Soliman: Using data from the REGARDS study, one of the largest US cohorts, we examined the risk of incident myocardial infarction (MI) associated with atrial fibrillation (AF). Overall, AF was associated with almost double the risk of MI. When we adjusted for common cardiovascular risk factors and potential confounders, the risk remained significantly high; about 70% increased risk. When we looked at women, men, blacks, and whites separately, we found significant differences between races and sex. AF in women and blacks was associated with more than double the risk of MI. This compares to less than 50% increased risk of heart attack associated with AF in men and whites . So AF is basically bad for all, but the risk of MI associated with AF is more pronounced in women and blacks.

MedicalResearch.com: Were any of the findings unexpected?

The striking racial and sex differences in the association between AF and MI is something we did not expect.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Soliman: Typically patients with AF are instructed on how to prevent stroke, which is a common complication of AF. Based on our findings, especially after having them replicated in other populations, it may be important to discuss the risk of heart attack as a potential complication of AF as well.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Soliman: As the case with any new findings, our results have to be replicated in other studies. Also, there is a need to investigate the reasons for race and sex differences in the association between AF and MI. Finally, we need to look for the optimal approach for prevention of MI in the setting of AF while still paying attention to the risk of stroke is needed.

Citation:

Soliman EZ, Safford MM, Muntner P, et al. Atrial Fibrillation and the Risk of Myocardial Infarction. JAMA Intern Med. 2013;():-. doi:10.1001/jamainternmed.2013.11912.