Outcomes of Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

BackgroundAtrial fibrillation (AF) is increasing in prevalence, and patients with a history of AF commonly undergo percutaneous coronary intervention (PCI). There is a paucity of contemporary data on the association between AF and clinical outcomes after PCI.ObjectivesThe study sought to evaluate the association between AF and in-hospital adverse outcomes using a large, prospective multicenter registry.MethodsData for consecutive PCI cases from 47 hospitals performed between April 2011 and December 2014 were utilized for the analysis. Propensity-matched multivariate analysis was used to adjust for differences in baseline characteristics between patients with and without a history of AF.ResultsOf 113,283 PCI cases during the study period, a history of AF was present in 13,912 patients (12%), which varied by institution (range 2.5% to 18.4%). At baseline, patients with a history of AF were older and were more likely to have comorbid congestive heart failure, cardiomyopathy, cerebrovascular disease, and chronic lung disease. Patients with a history of AF were more likely to have in-hospital complications, including in-hospital mortality (3% vs. 1%). In propensity-matched analysis, patients with a history of AF were more likely to be treated with a bare-metal stent (27% vs. 18%). In the propensity-matched model, AF remained independently associated with an increased risk of developing post-procedural bleeding (odds ratio [OR]: 1.32; 95% confidence interval [CI]: 1.15 to 1.52), heart failure (OR: 1.33; 95% CI: 1.17 to 1.52), cardiogenic shock (OR: 1.26; 95% CI: 1.08 to 1.48), and in-hospital mortality (OR: 1.41; 95% CI: 1.18 to 1.68).ConclusionsAF is common among patients undergoing PCI. AF is associated with older age, the presence of other comorbidities, and independently associated with in-hospital post-procedural heart failure, cardiogenic shock, and mortality.