Long-term risk of adverse outcomes according to atrial fibrillation type.

Publikation

Long-term risk of adverse outcomes according to atrial fibrillation type.

Wissenschaftlicher Artikel/Review - 09.02.2022

Blum Steffen, Aeschbacher Stefanie, Coslovsky Michael, Meyre Pascal B, Reddiess Philipp, Ammann Peter, Erne Paul, Moschovitis Giorgio, Di Valentino Marcello, Shah Dipen, Schläpfer Jürg, Müller Rahel, Beer Jürg H, Kobza Richard, Bonati Leo H, Moutzouri Elisavet, Rodondi Nicolas, Meyer-Zürn Christine, Kühne Michael, Sticherling Christian, Osswald Stefan, Conen David, BEAT-AF and Swiss-AF Investigators

Zitation

Blum S, Aeschbacher S, Coslovsky M, Meyre P, Reddiess P, Ammann P, Erne P, Moschovitis G, Di Valentino M, Shah D, Schläpfer J, Müller R, Beer J, Kobza R, Bonati L, Moutzouri E, Rodondi N, Meyer-Zürn C, Kühne M, Sticherling C, Osswald S, Conen D, BEAT-AF and Swiss-AF Investigators. Long-term risk of adverse outcomes according to atrial fibrillation type. Sci Rep 2022; 12:2208.

Art

Wissenschaftlicher Artikel/Review (Englisch)

Zeitschrift

Sci Rep 2022; 12

Veröffentlichungsdatum

09.02.2022

eISSN (Online)

2045-2322

Seiten

2208

Kurzbeschreibung/Zielsetzung

Sustained forms of atrial fibrillation (AF) may be associated with a higher risk of adverse outcomes, but few if any long-term studies took into account changes of AF type and co-morbidities over time. We prospectively followed 3843 AF patients and collected information on AF type and co-morbidities during yearly follow-ups. The primary outcome was a composite of stroke or systemic embolism (SE). Secondary outcomes included myocardial infarction, hospitalization for congestive heart failure (CHF), bleeding and all-cause mortality. Multivariable adjusted Cox proportional hazards models with time-varying covariates were used to compare hazard ratios (HR) according to AF type. At baseline 1895 (49%), 1046 (27%) and 902 (24%) patients had paroxysmal, persistent and permanent AF and 3234 (84%) were anticoagulated. After a median (IQR) follow-up of 3.0 (1.9; 4.2) years, the incidence of stroke/SE was 1.0 per 100 patient-years. The incidence of myocardial infarction, CHF, bleeding and all-cause mortality was 0.7, 3.0, 2.9 and 2.7 per 100 patient-years, respectively. The multivariable adjusted (a) HRs (95% confidence interval) for stroke/SE were 1.13 (0.69; 1.85) and 1.27 (0.83; 1.95) for time-updated persistent and permanent AF, respectively. The corresponding aHRs were 1.23 (0.89, 1.69) and 1.45 (1.12; 1.87) for all-cause mortality, 1.34 (1.00; 1.80) and 1.30 (1.01; 1.67) for CHF, 0.91 (0.48; 1.72) and 0.95 (0.56; 1.59) for myocardial infarction, and 0.89 (0.70; 1.14) and 1.00 (0.81; 1.24) for bleeding. In this large prospective cohort of AF patients, time-updated AF type was not associated with incident stroke/SE.