Oral anticoagulant therapy and outcomes in new-onset atrial fibrillation during acute myocardial infarction: A systematic review and meta-analysis

Table 1 Characteristics of studies included in the analysis, mean ± SD/median (interquartile range)

	Kayapinar et al[40]	Hofer et al[38]	Madsen et al[39]	Petersen et al[41]
Enrollment years	2009-2014	1996-2009	1999-2016	2000-2018
Study design	Retrospective single-center cohort study	Retrospective-prospective single-center cohort study	Retrospective single-center cohort study	Retrospective nationwide cohort study (Danish registry data)
Follow-up duration	1 year	Median 8.6 years	5.8 (3.6-9.3)	1 year
Patients with NOAF (n)	286	149	296	6427
Incidence	8.7%	10.9%	3.7%	4.0%
Definition of NOAF	No AF at admission; AF episode during hospitalization, spontaneously converted or successfully cardioverted (pharmacological/electrical) before discharge without recurrence	New AF episode at admission or during AMI in patients without prior AF	AF diagnosed within 30 days after STEMI in patients without prior AF	AF diagnosed at admission with ACS in patients without prior AF
Forms of NOAF	100% transient AF. Spontaneous rhythm restoration: 118 patients (41.3%). Pharmacological cardioversion: 121 patients (42.3%). Electrical cardioversion: 47 patients (16.4%)	Paroxysmal: 67.1% (100 of 149), AF episodes terminated before discharge. Persistent: 32.9% (49 of 149), AF persisted at discharge	Not reported	Not reported
Patients with STEMI	100%	59.1%	100%	Not reported (AMI in 90.0%)
PCI	100%	50.3%	100%	26.3%
CHA2DS2-VASc score	2.85 ± 1.8	4 (3-5)	CHA2DS2-VASc ≥ 2: 92.6%	3 (2-5)
HAS-BLED score	2.75 ± 1.3	Not reported	≥ 3 in 57.1%	1 (0-2)
Patients on OAC	40.6%	52.3%	38.2%	38.9%
Anticoagulant therapy	Warfarin	Warfarin	Warfarin (74.3%), DOACs (25.7%)	Warfarin and DOACs (distribution not specified)
All-cause mortality and OAC effect	18.9%; HR = 1.06 (95%CI: 0.52-1.95, P = 0.880)	Not reported	44.3%; HR = 0.69 (95%CI: 0.47-1.00, P = 0.049)	18.0%; HR = 0.72 (95%CI: 0.57-0.91)
Cardiovascular mortality and OAC effect	Not reported	62.4%; triple antithrombotic therapy: HR = 0.86 (95%CI: 0.45-0.92, P = 0.012). Dual antithrombotic therapy: HR = 0.97 (95%CI: 0.65-1.57, P = 0.346). Estimated HR (warfarin): 0.90 (95%CI: 0.68-1.15)	Not reported	Not reported
Ischemic stroke and OAC effect	10.1%; HR = 1.39 (95%CI: 0.57-3.18, P = 0.459)	Fatal cases only: 6.0%	11.1%; HR = 0.70 (95%CI: 0.33-1.49, P = 0.35)	1.9%; HR = 0.78 (95%CI: 0.41-1.47)
Major bleeding/bleeding requiring hospitalization and OAC effect	2.8%; HR = 3.37 (95%CI: 1.76-10.04, P = 0.012)	2.6%; not reported	19.6%; HR = 1.31 (95%CI: 0.75-2.27, P = 0.34)	5.7%; HR = 1.20 (95%CI: 0.87-1.65)
Minor bleeding and OAC effect	7.0%; HR = 2.28 (95%CI: 1.78-5.81, P = 0.024)	Not reported	Not reported	Not reported

NOAF: New-onset atrial fibrillation; STEMI: ST-elevation myocardial infarction; PCI: Percutaneous coronary intervention; OAC: Oral anticoagulant; AF: Atrial fibrillation; HR: Hazard ratio; CI: Confidence interval; AMI: Acute myocardial infarction; DOAC: Direct oral anticoagulant; ACS: Acute coronary syndrome.