AUTHOR=Li Mingxing , Gao Yingying , Guo Kai , Wu Zidi , Lao Yi , Li Jiewen , Huang Xuansheng , Feng Li , Dong Jianting , Yuan Yong 

TITLE=Association Between Fasting Hyperglycemia and New-Onset Atrial Fibrillation in Patients With Acute Myocardial Infarction and the Impact on Short- and Long-Term Prognosis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.667527

DOI=10.3389/fcvm.2021.667527

ISSN=2297-055X

ABSTRACT=Background: The relationship between fasting hyperglycemia (FHG) and new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI) is unclear, and whether their co-occurrence is associated with a worse in-hospital and long-term prognosis than FHG or AF alone is unknown.
Objective: To explore the correlation between FHG and new-onset AF in patients with AMI and their impact on in-hospital and long-term all-cause mortality. 
Methods: We performed a retrospective cohort study comprising 563 AMI patients. The patients were divided into the FHG group and the NFHG group. The incidence of new-onset AF during hospitalization was compared between the two groups and sub-groups under different Killip grades. Logistic regression was used to assess the association between FHG and new-onset AF. In-hospital mortality and long-term all-cause mortality were compared among patients with FHG, AF, and with both FHG and AF according to 10 years of follow-up information.
Results: New-onset AF occurred more frequently in the FHG group than in the NFHG group (21.6% vs 9.2%, p<0.001). This trend was observed for Killip grade I (16.6% vs. 6.5%, p=0.002) and Grade II (17.1% vs 6.9%, p= 0.005), but not for Killip grade III-IV (40% vs. 33.3%, p=0.761). Logistic regression showed FHG independently correlated with new-onset AF ( OR, 2.56; 95%CI, 1.53-4.30; P<0.001), and 1 mmol/L increased in fasting glucose was associated with a 5% higher rate of new-onset AF, after adjustment for traditional AF risk factors. AMI patients complicated with both fasting hyperglycemia and AF showed the highest in-hospital mortality and long-term all-cause mortality during an average of 11.2 years of follow-up. Multivariate Cox regression showed FHG combined with AF independently correlated with long-term all-cause mortality after adjustment for other traditional risk factors (OR=3.13，95% CI 1.64-5.96，p=0.001), compared with the group with neither FHG nor new-onset AF.
Conclusion: FHG was an independent risk factor for new-onset AF in patients with AMI. AMI patients complicated with both FHG and new-onset AF showed worse in-hospital and long-term all-cause mortality than with FHG or AF alone.