New-onset atrial fibrillation and chronic coronary syndrome in the CLARIFY registry
Author:
Gautier Alexandre12ORCID, Picard Fabien23ORCID, Ducrocq Gregory12ORCID, Elbez Yedid4, Fox Kim M5, Ferrari Roberto6, Ford Ian7ORCID, Tardif Jean-Claude8ORCID, Tendera Michal9, Steg Philippe Gabriel1210ORCID, Guerrero A Ahuad, Basara M, Belcastro F, Bertarini J A, Cazenave C, Dreycopp H, Egido J, Estrella J, Garofalo D, Giordano J, Lagioia H, Lago N, Greca R La, Lema L, Cabanillas N Lopez, Luquez H, Miller C, Prada E, Rodenas P, Schena R G, Suarez G, Tomatti A, Colquhoun D M, Conradie A, Cox S, Cross D, Fathi R, Fitzgerald B, Hamilton-Craig I, Holt G, Jayasinghe S R, Mai N, Moolman J, Motyer R A, Phillips K, Rafter A, Rahman A, Rainbird A, Scalia G, Taylor A, West P, Alford K, Amor R, Astridge P, Bastian B, Bates F, Doohan M M, Du Plooy J, Ford J C, Kanagaratnam L, Khoury V, Parkin R, Rogers J, Sceats G, Waldman A, Wang D, Wright S, Ardill J, Aylward P, Beltrame J F, Bradley J, Heddle W, Joseph M, Rajendran S, Varughese S, Brice E, Hockings B, Janssen J, Kozlowski A, O'Shea J, Tan J, Playford D A, Woollard K, Ajani A, Barron G, Better N, Carruthers T, Chan B, Chan R, Cotroneo J, Counsell J T, Eccleston D S, Forge B H R, Hamer A, Horrigan M, Jelinek V M J, Lew R, O'Donnell D, Panetta F, Sebastian M, Shetty P, Soward A, Srivastava P, Strathmore N F, Sylivris S, Szto G, Veth V, Yip T, Badr-Eslam R, Kleemann L, Steurer G, Mörz-Proszowski B, Auhser F, Teleky U, Sepp G, Beinhauer A, Kerö D, Lavicka C, Perger T, Hadjiivanov V, Feldner-Busztin M, Mika R, Filip W, Mahr A, Toplak J, Millauer M G, Haralambus P, Walcher K, Karner K H, Ziak E, Painsipp P, Frank U, Suntinger A, Gritsch W, Bode G, Herrmann R, Raffelsberger R, Topf H, Moser E, Föchterle J, Honsig T, Mayr K, Mayr H, Kaserbacher R, Dzien A, Galehr E, Felbermayer M, Schwarz R, Amini R, Appeltants H, Ballet A, De Niel C, Berkenboom G, Bernard X, Bouvy T, Claeys M, Dascotte Y, Davin L, De Backer T, De Meester A, De Ridder S, Dendale P, Denef K, Emonts M, Geraedts J T M, Goethals M, Grégoire J-M, Herbots T, Hoffer E, Hutse W H J, Lafontaine P, Lefebvre P, Lesseliers H, Odent G, Pasquet A, Peperstraete B, Purnode P, Rogowsky A, Rosseel M, Salembier J-P, Surmont P, Vandeplas A M F, Van De Walle S, Van den Branden F, Vandergoten P, Vanhauwaert B G, Vanneste L, Vercammen J, Verleyen D, Vermander D, Weytjens C, De Lorenzo A Rocha, Issa A Felice Castro, Mioto B Mahler, Vianna C de Brito, Okawabata C, Rossi E Giusti, Fernandes F, Pitella F, Cesena F Henpin Yue, Ferreira J F Monteiro, Junior J F, Tonet L, Cesar L Machado, Gowdak L H, Matos M A, Moretti M, Amato R Vicente, Munhoz R Tadeu, Coimbra S R, De Lorenzo A Rocha, Issa A Felice Castro, Mioto B Mahler, Vianna C de Brito, Okawabata C, Rossi E Giusti, Fernandes F, Pitella F, Cesena F Henpin Yue, Ferreira J F Monteiro, Junior J F, Tonet L, Cesar L Machado, Gowdak L H, Matos M A, Moretti M, Amato R Vicente, Munhoz R Tadeu, Coimbra S R, Luqman H N, Yakovova S, Mantcheva M, Mincheva V, Baurenski L, Karastanev K, Yordanova V, Peneva Y, Wong P, Fagan M, Sabe-Affaki G, Villasenor F M, Son W K, Manyari D E, Giacomantonio N, Lubelsky B J, Ezekiel D, Leong J C S, Grover A, Vavougios J, Pesant Y, Kushner A M, Yeung M M W, Vertes G E, Nasser-Sharif F J, Spensieri D, Roy A, Nguyen T T, Leclair M, Morra P, Biglow C Everton, Baril J F, Lai K, Wong D S, Martinho V, Antoniadis G A, Searles G R, Rouse D, Brisson G, Wong S King, Collette R S, Ho M S C, Constance C, Gendreau R, Kellam G W, Lara T A Cieza, Boyrazian H A, Shamsuzzaman M, Spink D R, T Wong A P, Janes J, Czarnecka M, Saulnier D, Levesque G, Clavette P F, Kokis A, Orenstein-Lyall T L, Pandey A Shekhar, Robb J, Verret G, Czarnecki W, Perreault F, Chouinard G, Lafrance G, Fullerton G M, LeBouthillier P, Tran Q H, Marrero I Rodriguez, Ramadan F B, Talbot P, Fazil M A, Cha J Yi-Ming, Garg S, Chehayeb R, Roy B, Chan Y K, Harlos H E, Matheson H B, Patel R, Vaz G F, Bhatt J S, Liu E, Ashton T H, Sullivan H, Quinn L P, Yared K, Gupta A K, Sullivan B, Campbell J, Pallie S, Kim H H, Savard D, Cherry J M, Gold J, Brouillette G, Belanger A, Berlingieri J, Nisker W, Boutros G, Bakbak A I, Lasalle L, Chen L L, Chen M H, Chen M Y, Chen X P, Chen Y D, Cong H L, Ding S F, Dong J T, Dong S H, Du Z M, Feng L L, Gao W, Ge H, Ge S J, Guo T, Guo Y, Huang Z, Huo Y, Jin H G, Ke Y N, Li H W, Li H M, Li Z C, Li Y J, Liu J L, Liu Q L, Liu S W, Lv S Z, Miao W, Pan G Z, Pu X D, Qian Z M, Su X, Tao J H, Wang H P, Wang J A, Wang N F, Wang T, Wang W, Wang Y, Wei M, Wu S Y, Wu Y J, Xiong L G, Xu D, Yan J, Yang K, Yang M, Yang T L, Yang X L, Yu J M, Zeng H S, Zhang H, Zhang H Q, Zhang L, Zhou S X, Zhou Y L, Bozkova J, Carda J, Dedkova S, Dufka A, Fridrich J, Hodac T, Jirmar R, Kadleckova A, Karlicek M, Krupicka J, Kuchar J, Lavicka V, Leso J, Lorenc Z, Micko M, Navratil P, Petrova I, Povolna P, Raisova L, Raska P, Ravlyk V, Schlesingerova S, Smrckova E, Sternthal P, Stursova H, Vymetal P, Wiggers P, Markenvard J, Andersen L K, Frost L, Refsgaard J, Strange S, Egstrup K, Sykulski R, Hildebrant P, Haghfelt T, Ege M, Saaby L, Cattan S, Adam-Blanpain M, Adda M, Aimouch N, Ardouin L, Assouline S, Aumjaud A, Barjhoux C, Baroudi R, Beaurain C, Bennouna M A, Bernard A, Bernardeau C, Blanc E, Blum-Decary I, Bodur G, Boesch C, Bonal J, Bonhomme R, Bonnet J L, Bories J, Bourachot M L, Brumelot F, Petaut M Brunehaut, Brunschwig C, Buffet P, Calmettes P, Centa I, Chartier B, Chemin P, Chometon F, Cohen J, Colin R, Cottin Y, Crespo F, Dabboura A, David F, Dehayes P, Dematteo P, Dibon O, Dodemant P, Dormagen V, Dreyfus X, Dubois J M, Duclos F, Ducoudre M, Duprez O, Durand P, Durand E, Egloff P, Escande M, Berdou M C Escourrou, Ashari G Esna, Feldmann I, Ferrieres J, Foltzer E, Fontanet B, Garandeau M, Garban T, Geffroy S, Gillet T, Godart S, Gosse P, Gratia P, Greiner O, Gueusquin A, Guiu E, Guy J M, Haddad S, Hennebelle V, Honorat S, Hourany A, Hua G, Jacquier P, Jean S, Jeremiasz R, Kohler P, Lacroix A, Leandri M, Lemiere Y, Liautard M, Loheac P, Louchart J C, Magnus P, Maheu B, Malaterre H R, Manchet G, Mantoux J, Manzi D, Marachli M, Maroun M, Meneveau N, Messas E, Mougeolle J L, Mouhat T, Muller J, Naisseh M, Nocon P, Onger D, Ouguoujil A, Ovize M, Page E, Pareathumby K, Pleskof A, Poinson P, Pons G, Pouderou P, Poujois J N, Probst V, Prunier F, Prunier L, Puel V, Rechtman D, Rennert R, Rijavec B, Riou Y, Robert J, Roche C, Roul G, Salaun B, Saleh B, Sandalian A, Sander M, Schenowitz A, Silvestre A, Soleille H, Tabet S, Tardy M, Thomas-Richard F, Truong B, Varaldi J, Vial H, Walch J M, Wazana M, Zeitouni R, Audibert H, Alizon F, Amlaiky A, Asplanato M, Baranes C, Bariaud M, Bernasconi F, Bousquet P, Ceraulo C, De Geeter G, Donetti J, Doucet B, Doucet J, Dutoya T, Ennouchi D, Fallacher M H, Fouquet G, Fourchard V, Gdalia J, Grollier G, Guerard S, Jeannerat P A, Jobic Y, Joulie V, Jourdain P, Jouve V, Ketelers R, Khaznadar G, Kohan P, Koujan B, Lammens B, Landragin I, Moal E Le, M'Bey D, Maes F, Morlet S Maheas, Massabie R, Meddah D, Meriaux F X, Mestre-Fernandes C, 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Affiliation:
1. Department of Cardiology, Hôpital Bichat , Assistance Publique-Hôpitaux de Paris, French Alliance for Cardiovascular Trials, INSERM U1148, Laboratory for Vascular Translational Science, 46 rue Henri Huchard, 75018 Paris, France 2. Université Paris Cité , 85 boulevard Saint-Germain, 75006 Paris , France 3. Department of Cardiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, French Alliance for Cardiovascular Trials , 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France 4. Signifience , 35 rue de l'Oasis, 92800 Puteaux , France 5. NHLI Imperial College , Dovehouse Street, London SW3 6LP , UK 6. Centro Cardiologico Universitario di Ferrara, University of Ferrara, Via Aldo Moro 8, 44124 Cona (FE) Italy, Scientific Department of Medical Trial Analysis (MTA), Via Antonio Riva 6, 6900, Lugano, Switzerland 7. Robertson Centre for Biostatistics, Boyd Orr Building, University Avenue, University of Glasgow, Glasgow G12 8QQ, UK 8. Montreal Heart Institute, Université de Montreal , 5000 Belanger Street, Montreal, QC H1T 1C8 , Canada 9. Department of Cardiology and Structural Heart Disease, School of Medicine in Katowice, Medical University of Silesia , Ziolowa Street 45/47, 40-635 Katowice , Poland 10. Institut Universitaire de France , 1 Rue Descartes, 75005 Paris , France
Abstract
Abstract
Background and aims
Data on new-onset atrial fibrillation (NOAF) in patients with chronic coronary syndromes (CCS) are scarce. This study aims to describe the incidence, predictors, and impact on cardiovascular (CV) outcomes of NOAF in CCS patients.
Methods
Data from the international (45 countries) CLARIFY registry (prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) were used. Among 29 001 CCS outpatients without previously reported AF at baseline, patients with at least one episode of AF/flutter diagnosed during 5-year follow-up were compared with patients in sinus rhythm throughout the study.
Results
The incidence rate of NOAF was 1.12 [95% confidence interval (CI) 1.06–1.18] per 100 patient-years (cumulative incidence at 5 years: 5.0%). Independent predictors of NOAF were increasing age, increasing body mass index, low estimated glomerular filtration rate, Caucasian ethnicity, alcohol intake, and low left ventricular ejection fraction, while high triglycerides were associated with lower incidence. New-onset atrial fibrillation was associated with a substantial increase in the risk of adverse outcomes, with adjusted hazard ratios of 2.01 (95% CI 1.61–2.52) for the composite of CV death, non-fatal myocardial infarction, or non-fatal stroke, 2.61 (95% CI 2.04–3.34) for CV death, 1.64 (95% CI 1.07–2.50) for non-fatal myocardial infarction, 2.27 (95% CI 1.85–2.78) for all-cause death, 8.44 (95% CI 7.05–10.10) for hospitalization for heart failure, and 4.46 (95% CI 2.85–6.99) for major bleeding.
Conclusions
Among CCS patients, NOAF is common and is strongly associated with worse outcomes. Whether more intensive preventive measures and more systematic screening for AF would improve prognosis in this population deserves further investigation.
Publisher
Oxford University Press (OUP)
Subject
Cardiology and Cardiovascular Medicine
Cited by
8 articles.
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