The Impact of Atrial Fibrillation on the Long-term Outcomes of Hypertrophic Cardiomyopathy Patients with Acute Myocardial Infarction

Abstract Objective Atrial fibrillation (AF) is the most common arrhythmia in hypertrophic cardiomyopathy (HCM). Meanwhile, antithrombotic therapy for AF patients with acute myocardial infarction (AMI) is a worldwide problem. Therefore, AF plays a very important role in AMI patients with HCM. The main objective of this study is to investigate the long-term prognosis of patients which are AMI and HCM with or without AF. Methods A total of 78 HCM and AMI patients with or without AF were enrolled. Major adverse cardiac events (MACEs) (including cardiac death, cardiogenic shock, AMI, repercutaneous coronary intervention, re-coronary artery bypass grafting and stroke) and secondary endpoints (including rehospitalization, recurrent angina, thrombosis, bleeding, heart failure and arrhythmias) were recorded in-hospital and during the 5-year follow up. Results There were no differences in observed in-hospital and 5-year mortality between the two groups. The incidence of stroke in AF group was significantly higher than that in non-AF group (20.6% VS. 0%, P = 0.017). The 5-year outcomes including MACEs and secondary endpoints were both inferior to the group without AF (log-rank P = 0.021 and 0.001, respectively). Conclusion AMI and HCM patients with AF exhibited worse long-term outcomes than patients without AF. More attention should be paid to the antithrombotic therapy in patients with AMI and HCM complicated with AF.