AFib May Push Heart Attack Risk Higher

Atrial fibrillation increased likelihood of heart attack especially in women and African Americans

(RxWiki News) Atrial fibrillation (AFib) is an irregular heart rhythm. While heart attack increases the risk of AFib, AFib may also raise heart attack risk, especially in women and African Americans.

For years, doctors have known that AFib patients are more likely to have strokes, but a new study found that these patients also may face a greater chance of having a heart attack.

"Discuss strategies to prevent heart attack with your doctor."

Elsayed Soliman, MD, director of the Epidemiological Cardiology Research Center (EPICARE) at Wake Forest Baptist in Winston-Salem, North Carolina, and his colleagues identified 1,631 patients with AFib from a study of 23,928 participants.

Over about seven years of follow-up, the researchers noted 78 heart attacks in those patients with AFib and 570 heart attacks in the 22,297 patients without AFib.

Those with AFib had an overall increase of heart attack risk of 70 percent compared to those without AFib.

Women and African Americans with AFib, in particular, had a dramatic climb in heart attack risk. For these two groups, the likelihood of heart attack was more than double compared to those without AFib.

In men and whites with AFib, the increased risk of heart attack was less than 50 percent.

Dr. Soliman told dailyRx News, “AFib is bad for all, but the risk of heart attack associated with AFib is more pronounced in women and blacks.”

More than 2.5 million American adults and 4.5 million people living in the European Union are affected by AFib, according to the Heart Rhythm Society. The number of people diagnosed with AFib in the US is expected to more than double in the next 30 to 40 years.

In a subgroup analysis in this study, the researchers examined the risk of heart attacks associated with AFib in participants taking blood thinners compared to those not taking blood thinners.

Dr. Soliman and his team found that the risk of heart attacks associated with AFib was double in the group not taking the blood thinners. On the other hand, there was no significant association between AFib and heart attacks in the group taking blood thinners.

“These findings suggest a potential benefit of blood thinners in prevention of heart attacks in patients with AFib,” said Dr. Soliman. “However, this needs to be investigated in a clinical trial aimed to address this question.”

In additional comments to dailyRx News, Dr. Soliman said, “Typically, patients with AFib are instructed on how to prevent stroke, which is a common complication of AFib. Based on our findings, it may be important to discuss the risk of heart attack as a potential complication of Afib as well."

This study was published on November 4 in JAMA Internal Medicine.

Review Date: 
November 4, 2013