Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors: an RE-LY AF registry analysis-Reference-Cited by-同舟云学术

Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors: an RE-LY AF registry analysis

Published:2020-03-26 Issue:6 Volume:22 Page:870-877
ISSN:1099-5129
Container-title:EP Europace
language:en
Short-container-title:

Author:

Kloosterman Mariëlle¹,Oldgren Jonas²,Conen David³,Wong Jorge A³^ORCID,Connolly Stuart J³,Avezum Alvaro⁴,Yusuf Salim³,Ezekowitz Michael D⁵,Wallentin Lars²^ORCID,Ntep-Gweth Marie⁶,Joseph Philip³,Barrett Tyler W⁷^ORCID,Tanosmsup Supachai⁸,McIntyre William F³^ORCID,Lee Shun Fu³^ORCID,Parkash Ratika⁹,Amit Guy³,Grinvalds Alex³,Van Gelder Isabelle C¹,Healey Jeff S³

Affiliation:

1. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

2. Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden

3. Population Health Research Institute, Department of Medicine, McMaster University, 30 Birge St. Room C3-121, Hamilton, Ontario L8L 0A6, Canada

4. Division of Cardiology, Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil

5. Department of Medicine, Medical College and Lankenau Medical Center, Wynnewood, PA, USA

6. Department of Medicine, Hôpital Central de Yaoundé, Yaounde, Cameroon

7. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

8. Department of Medicine, Mahidol University, Bangkok, Thailand

9. Department of Medicine, Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Nova Scotia, Canada

Abstract

Abstract Aims Data on patient characteristics, prevalence, and outcomes of atrial fibrillation (AF) patients without traditional risk factors, often labelled ‘lone AF’, are sparse. Methods and results The RE-LY AF registry included 15 400 individuals who presented to emergency departments with AF in 47 countries. This analysis focused on patients without traditional risk factors, including age ≥60 years, hypertension, coronary artery disease, heart failure, left ventricular hypertrophy, congenital heart disease, pulmonary disease, valve heart disease, hyperthyroidism, and prior cardiac surgery. Patients without traditional risk factors were compared with age- and region-matched controls with traditional risk factors (1:3 fashion). In 796 (5%) patients, no traditional risk factors were present. However, 98% (779/796) had less-established or borderline risk factors, including borderline hypertension (130–140/80–90 mmHg; 47%), chronic kidney disease (eGFR < 60 mL/min; 57%), obesity (body mass index > 30; 19%), diabetes (5%), excessive alcohol intake (>14 units/week; 4%), and smoking (25%). Compared with patients with traditional risk factors (n = 2388), patients without traditional risk factors were more often men (74% vs. 59%, P < 0.001) had paroxysmal AF (55% vs. 37%, P < 0.001) and less AF persistence after 1 year (21% vs. 49%, P < 0.001). Furthermore, 1-year stroke occurrence rate (0.6% vs. 2.0%, P = 0.013) and heart failure hospitalizations (0.9% vs. 12.5%, P < 0.001) were lower. However, risk of AF-related re-hospitalization was similar (18% vs. 21%, P = 0.09). Conclusion Almost all patients without traditionally defined AF risk factors have less-established or borderline risk factors. These patients have a favourable 1-year prognosis, but risk of AF-related re-hospitalization remains high. Greater emphasis should be placed on recognition and management of less-established or borderline risk factors.

Funder

Canadian Stroke Prevention Intervention Network

Canadian Institutes of Health Research

CIHR

Bohringer-Ingelheim

Abbott Medical

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Link

http://academic.oup.com/europace/article-pdf/22/6/870/33341797/euz360.pdf