Acute atrial fibrillation in type 2 myocardial infarction: A national analysis of incidence and in-hospital outcomes

Ben Thiravetyan MD, Napat Suriyathumrongkul MD, Sireethorn Wonghanchai MD, Varote Shotelersuk MD, Nisha Wanichwecharungruang MD, Nattanicha Chaisrimaneepan MD, Panat Yanpiset MD, Chanokporn Puchongmart MD

ABSTRACT

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia linked to worse outcomes. However, data on AF in type 2 myocardial infarction (T2MI), characterized by oxygen supply-demand mismatch without coronary occlusion, are limited.

Objective: To evaluate the incidence of acute AF in patients hospitalized with T2MI and its association with in-hospital outcomes.

Methods: We conducted a retrospective cohort study using the National Inpatient Sample from 2017 to 2022. Adult patients hospitalized with T2MI were included, excluding those with chronic AF. The primary outcome was the incidence of acute AF. Secondary outcomes were in-hospital mortality, cardiogenic shock, acute kidney injury (AKI), and bleeding. Survey-weighted analyses and multivariable logistic regression were used to calculate adjusted odds ratios.

Results: Among patients with T2MI, acute AF occurred in 31.3%. Patients with AF were older and had more comorbidities. In-hospital mortality, cardiogenic shock, and AKI were higher in the AF group compared to non-AF group. After adjustment, acute AF was independently associated with in-hospital mortality (aOR 1.17, 95% CI: 1.14–1.20) and cardiogenic shock (aOR 1.46, 95% CI: 1.40–1.51).

Conclusions: Acute AF is common in T2MI hospitalizations and is associated with mortality and cardiogenic shock.

Keywords: Atrial fibrillation, myocardial infarction, type 2 myocardial infarction, demand ischemia


Article citation: Thiravetyan B, Suriyathumrongkul N, Wonghanchai S, Shotelersuk V, Wanichwecharungruang N, Chaisrimaneepan N, Yanpiset P. Acute atrial fibrillation in Type 2 Myocardial Infarction: A national analysis of incidence and in-hospital outcomes. 2026;14(61):36–43
From: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX (BT, NS, VS, NW, NC, PY, CP) Department of Family Medicine, Chakri Naruebodindra Medical Institute, Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
Conflicts of interest: none
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.