Factors Associated with Progression of Atrial Fibrillation and Impact on All-Cause Mortality in a Cohort of European Patients

Autor: Marco Vitolo, Marco Proietti, Jacopo F. Imberti, Niccolò Bonini, Giulio Francesco Romiti, Davide A. Mei, Vincenzo L. Malavasi, Igor Diemberger, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana S. Potpara, Gheorghe-Andrei Dan, Gregory Y. H. Lip, Giuseppe Boriani
Rok vydání: 2023
Předmět:
Zdroj: Vitolo, M, Proietti, M, Imberti, J F, Bonini, N, Romiti, G F, Mei, D A, Malavasi, V L, Diemberger, I, Fauchier, L, Marin, F, Nabauer, M, Potpara, T S, Dan, G-A, Lip, G Y H & Boriani, G 2023, ' Factors Associated with Progression of Atrial Fibrillation and Impact on All-Cause Mortality in a Cohort of European Patients ', Journal of Clinical Medicine, vol. 12, no. 3, 768 . https://doi.org/10.3390/jcm12030768
Journal of Clinical Medicine
Volume 12
Issue 3
Pages: 768
ISSN: 2077-0383
Popis: Background: Paroxysmal atrial fibrillation (AF) may often progress towards more sustained forms of the arrhythmia, but further research is needed on the factors associated with this clinical course. Methods: We analyzed patients enrolled in a prospective cohort study of AF patients. Patients with paroxysmal AF at baseline or first-detected AF (with successful cardioversion) were included. According to rhythm status at 1 year, patients were stratified into: (i) No AF progression and (ii) AF progression. All-cause death was the primary outcome. Results: A total of 2688 patients were included (median age 67 years, interquartile range 60–75, females 44.7%). At 1-year of follow-up, 2094 (77.9%) patients showed no AF progression, while 594 (22.1%) developed persistent or permanent AF. On multivariable logistic regression analysis, no physical activity (odds ratio [OR] 1.35, 95% CI 1.02–1.78), valvular heart disease (OR 1.63, 95% CI 1.23–2.15), left atrial diameter (OR 1.03, 95% CI 1.01–1.05), or left ventricular ejection fraction (OR 0.98, 95% CI 0.97–1.00) were independently associated with AF progression at 1 year. After the assessment at 1 year, the patients were followed for an extended follow-up of 371 days, and those with AF progression were independently associated with a higher risk for all-cause death (adjusted hazard ratio 1.77, 95% CI 1.09–2.89) compared to no-AF-progression patients. Conclusions: In a contemporary cohort of AF patients, a substantial proportion of patients presenting with paroxysmal or first-detected AF showed progression of the AF pattern within 1 year, and clinical factors related to cardiac remodeling were associated with progression. AF progression was associated with an increased risk of all-cause mortality.
Databáze: OpenAIRE
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