Afib May Spark MI

Atrial fibrillationAlthough myocardial infarction is a known risk factor for the development of atrial fibrillation, the relationship might work the other way around, too, researchers found.

Among patients without a history of coronary heart disease, those with atrial fibrillation were 70% more likely to have an MI through an average of about 7 years of follow-up after accounting for other potential risk factors (HR 1.70, 95% CI 1.26-2.30), according to Elsayed Soliman, MD, of Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues.

That risk was greatest among women (HR 2.16, 95% CI 1.41-3.31) and black individuals (HR 2.53, 95% CI 1.67-3.86), they reported online in JAMA Internal Medicine.

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Which Antithrombotic Strategy Is Best in AF Patients Hospitalized for Coronary Artery Disease?

A large Danish registry study suggests that dual anticoagulant–antiplatelet therapy is as effective as triple therapy including aspirin.

The main finding from this large observational study is that outcomes with a combination of an anticoagulant and clopidogrel are comparable to those of triple therapy with regard to ischemic endpoints as well as bleeding. Possibly more important are the findings that dual antiplatelet therapy alone was associated with increased rates of ischemic stroke and all-cause mortality, and anticoagulant–aspirin therapy with increased mortality. The findings support the results of a small trial (NEJM JW Cardiol Feb 27 2013) suggesting that the optimal regimen for stent recipients with atrial fibrillation is an anticoagulant plus clopidogrel.

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