Work

Clinical Profiles and In‐Hospital Outcomes of Pre‐Existing Versus Newly Diagnosed Atrial Fibrillation in Coronary Care Units: Insights From the MORCOR‐TURK National Registry

Year: 2025

Type: article

Abstract: ABSTRACT Objective To compare demographic, clinical, and laboratory profiles and short‐term outcomes between pre‐existing (chronic) atrial fibrillation (AF) and newly diagnosed AF among patients admitted to coronary care units (CCUs) in Turkey, and to identify factors associated with in‐hospital mortality within AF subtypes. Methods This multicenter, prospective national registry analysis included 540 consecutive AF patients from 50 CCU centers across seven geographic regions in Turkey (MORCOR‐TURK National Registry; September 1–30, 2022). Patients were categorized as pre‐existing AF (documented AF prior to or at admission) or newly diagnosed AF (first detected during hospitalization). Demographics, comorbidities, admission diagnoses, laboratory biomarkers (including NT‐proBNP and hs‐troponin I), management, and outcomes were recorded. Multivariable logistic regression identified independent predictors of in‐hospital mortality. Results Pre‐existing AF ( n = 324) had higher prevalences of diabetes mellitus (42.3% vs. 31.5%; p = 0.012) and acute coronary syndromes (58.6% vs. 34.7%; p < 0.001). Newly diagnosed AF ( n = 216) more frequently presented with heart failure (45.8% vs. 28.4%; p < 0.001) and dyspnea (67.1% vs. 48.5%; p < 0.001). Newly diagnosed AF exhibited higher inflammatory burden (CRP median 28.4 vs. 12.6 mg/L; p < 0.001) and lower hemoglobin (11.8 ± 2.1 vs. 12.9 ± 1.8 g/dL; p < 0.001). NT‐proBNP was elevated in both groups and higher in newly diagnosed AF (median 4850 vs. 3240 pg/mL; p = 0.003). In‐hospital mortality was greater with newly diagnosed AF (12.0% vs. 6.8%; p = 0.042). Independent mortality predictors included age, chronic kidney disease, cardiogenic shock, and log‐transformed NT‐proBNP, hs‐troponin I, and CRP. Conclusion In Turkish CCUs, pre‐existing and newly diagnosed AF constitute distinct clinical phenotypes with differing presentations, biomarker profiles, and short‐term risk. Newly diagnosed AF is associated with greater inflammatory and hemodynamic stress and higher in‐hospital mortality. Biomarker‐enriched risk stratification may refine prognostication and guide targeted management within AF subtypes.

Source: Journal of Arrhythmia

DOI: 10.1002/joa3.70238