PMID- 34551942 OWN - NLM STAT- MEDLINE DCOM- 20211020 LR - 20211020 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 11 IP - 9 DP - 2021 Sep 22 TI - Retrospective cohort study of new-onset atrial fibrillation in acute pulmonary embolism on prognosis. PG - e047658 LID - 10.1136/bmjopen-2020-047658 [doi] LID - e047658 AB - OBJECTIVES: To investigate the characteristics of new-onset atrial fibrillation (AF) and its impact on prognosis in acute pulmonary embolism (aPE). DESIGN: A retrospective cohort study SETTING: The study cohort included patients diagnosed with aPE who were admitted to the Renmin Hospital of Wuhan University from January 2017 to January 2019. PARTICIPANTS: Patients were >/=18 years of age and hospitalised for aPE. OUTCOME MEASURES: AF was diagnosed based on an ECG recording or a Holter monitor during hospitalisation. aPE was diagnosed by CT pulmonary angiography. The prescription was determined from the discharge medication list. All-cause mortality was observed after 6-month follow-up. The logistic regression model and Cox proportional hazards model were used to study the risk factor of the new-onset AF and the predictor of all-cause mortality, respectively. RESULTS: A total of 590 patients with aPE were enrolled, 23 (3.9%) in the new-onset paroxysmal AF group, 31 (5.3%) in the new-onset persistent AF group and 536 (90.8%) in the sinus rhythm (SR) group. The incidence of the new-onset AF was 9.2% (54/590). A significant difference in age, heart rate, cardiac troponin I ultra, amino-terminal pro-brain natriuretic peptide, D-dimer, left atrial diameter, left ventricular ejection fraction, pulmonary infection, venous thromboembolism, congestive heart failure, chronic cor pulmonale and ischaemic heart disease was found among the three groups (p<0.05). Risk factors for the new-onset AF were massive PE, ischaemic heart disease and congestive heart failure. The survival rate of the paroxysmal and persistent AF group was significantly lower than that of the SR group within 6 months (60.9% and 51.6% vs 88.8%, p<0.001). New-onset persistent AF (OR 2.73; 95% CI 1.28 to 5.81; p=0.009) was an independent predictor affecting the 6-month survival in aPE patients. CONCLUSIONS: Massive PE, ischaemic heart disease and congestive heart failure are high-risk factors which were related to new-onset AF in aPE. New-onset persistent AF was an independent predictor for 6-month all-cause mortality in PE patients. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Liu, Dishiwen AU - Liu D AUID- ORCID: 0000-0001-5269-5754 AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Shi, Shaobo AU - Shi S AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Liu, Xin AU - Liu X AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Ye, Tianxin AU - Ye T AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Wang, Linglin AU - Wang L AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Qu, Chuan AU - Qu C AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Yang, Bo AU - Yang B AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. FAU - Zhao, Qingyan AU - Zhao Q AD - Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China ruyan71@163.com. AD - Cardiovascular Research Institute, Wuhan, People's Republic of China. AD - Hubei Key Laboratory of Cardiology, Wuhan, People's Republic of China. LA - eng PT - Journal Article DEP - 20210922 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 SB - IM MH - *Atrial Fibrillation/complications/epidemiology MH - *Heart Failure/epidemiology/etiology MH - Humans MH - Prognosis MH - *Pulmonary Embolism/epidemiology/etiology MH - Retrospective Studies MH - Stroke Volume MH - Ventricular Function, Left PMC - PMC8461272 OTO - NOTNLM OT - cardiology OT - intensive & critical care OT - thromboembolism COIS- Competing interests: None declared. EDAT- 2021/09/24 06:00 MHDA- 2021/10/21 06:00 PMCR- 2021/09/22 CRDT- 2021/09/23 05:56 PHST- 2021/09/23 05:56 [entrez] PHST- 2021/09/24 06:00 [pubmed] PHST- 2021/10/21 06:00 [medline] PHST- 2021/09/22 00:00 [pmc-release] AID - bmjopen-2020-047658 [pii] AID - 10.1136/bmjopen-2020-047658 [doi] PST - epublish SO - BMJ Open. 2021 Sep 22;11(9):e047658. doi: 10.1136/bmjopen-2020-047658.