Prognosis of various atrial fibrillation patterns in the general population

Autor: M J Tilly, Z Lu, S Geurts, B H Stricker, J A Labrecque, M K Ikram, M P M De Maat, N M S De Groot, M Kavousi
Rok vydání: 2023
Předmět:
Zdroj: European Journal of Preventive Cardiology. 30
ISSN: 2047-4881
2047-4873
DOI: 10.1093/eurjpc/zwad125.203
Popis: Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Senior Scientist Grant from the Dutch Heart Foundation. Aims Due to their dependence on temporality, current atrial fibrillation (AF) classifications are inaccurate and impractical in large cohort studies, resulting in scarce evidence on prognostic differences between AF patterns in the general population. Using our recently developed AF classification, we investigated potential differences in cardiovascular prognosis among participants with various AF patterns and matched non-AF individuals from the general population. Methods 1,111 individuals from the general population were classified as 'single-documented AF episode' (sAF), 198 as 'multiple-documented AF episodes' (mAF), and 52 as 'longstanding persistent AF' (lpAF). Each group was independently matched with non-AF participants through propensity score matching. Participants were followed for the development of coronary heart syndrome (CHD), stroke, heart failure (HF), and cardiovascular mortality. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for each AF pattern. Results Stroke risk was 1.01; 0.82-1.28 (HR; 95% CI) for sAF, 1.36; 0.87-2.11 for mAF, and 1.44; 0.79-3.54 for lpAF, as compared to their matched participants. HF risk was larger in all AF patterns, with the gradient corresponding to AF severity: 3.48; 1.61-7.55 for lpAF, 2.78; 1.94-3.98 for mAF, and 1.71; 1.44-2.03 for sAF. Compared to non-AF participants, cardiovascular mortality risk was larger in the sAF (1.56; 1.37-1.79) and mAF (1.53; 1.11-2.12) categories, but not for lpAF (0.85; 0.40-1.82). Conclusion More severe AF patterns in the general population carried a larger HF risk. We observed a trend regarding a larger stroke risk in more severe AF patterns, albeit statistically not significant. Our new AF classification method may benefit comorbidity and mortality risk stratification associated with AF in a general population.
Databáze: OpenAIRE
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