Risk factors for mortality in acute myocardial infarction / Authors' reply

Since atrial fibrillation developed in older and sicker patients, their worse prognosis may be mostly due to their worse risk profile. In the Intravenous NPA for Treatment of Infarcting Myocardium Early (InTIME) II Study,(1) 15 078 patients were recruited and randomly assigned, in a 2:1 ratio, lanoteplase or accelerated alteplase. On admission, 587 (3.5%) patients had atrial fibrillation and 1171 (7.9%) patients had any atrial fibrillation during hospital stay.' The 30-day mortality rate was significantly higher in patients with any atrial fibrillation than in patients without atrial fibrillation, as it was for non-fatal strokes. However, in multiple regression analysis atrial fibrillation at any time was not a significant predictor of mortality.