Oral anticoagulation for atrial fibrillation after ST-elevation myocardial infarction: new evidence to guide clinical practice.

Atrial fibrillation (AF) in the setting of ST-segment elevation myocardial infarction (STEMI) is estimated to occur in up to 20% of patients, depending on the population studied.1–3 The development of AF during hospitalization for STEMI is associated with a significant increase in both in-hospital and short-term mortality (odds ratio, 1.4 to 1.98).3 Predictors of developing AF include increased age, magnitude of creatine kinase elevation, Killip class, anterior location of infarction, left ventricular dysfunction, and both hypertension and hypotension. Those patients who develop AF during their hospitalization have a worse prognosis than those who present with AF on admission.1 Even in the fibrinolytic era, stroke rates are increased in STEMI patients with AF.4