Long-term risk of adverse outcomes according to atrial fibrillation type Academic Article uri icon

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abstract

  • AbstractSustained 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.

authors

  • 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
  • Aeschbacher, Stefanie
  • Auberson, Chloé
  • Blum, Steffen
  • Bonati, Leo
  • Ceylan, Selinda
  • Conen, David
  • Evers-Doerpfeld, Simone
  • Eken, Ceylan
  • Girod, Marc
  • Hennings, Elisa
  • Herber, Elena
  • Iten, Vasco
  • Krisai, Philipp
  • Lampart, Maurin
  • Lischer, Mirko
  • Meyer-Zürn, Christine
  • Meyre, Pascal
  • Monsch, Andreas U
  • Müller, Christian
  • Paladini, Rebecca E
  • Springer, Anne
  • Sticherling, Christian
  • Szucs, Thomas
  • Völlmin, Gian
  • Osswald, Stefan
  • Kühne, Michael
  • Aujesky, Drahomir
  • Fischer, Urs
  • Fuhrer, Juerg
  • Roten, Laurent
  • Jung, Simon
  • Mattle, Heinrich
  • Netzer, Seraina
  • Adam, Luise
  • Aubert, Carole Elodie
  • Feller, Martin
  • Loewe, Axel
  • Moutzouri, Elisavet
  • Schneider, Claudio
  • Flückiger, Tanja
  • Groen, Cindy
  • Ehrsam, Lukas
  • Hellrigl, Sven
  • Nuoffer, Alexandra
  • Rakovic, Damiana
  • Schwab, Nathalie
  • Wenger, Rylana
  • Saffari, Tu Hanh Zarrabi
  • Rodondi, Nicolas
  • Reichlin, Tobias
  • Beynon, Christopher
  • Dillier, Roger
  • Deubelbeiss, Michèle
  • Eberli, Franz
  • Franzini, Christine
  • Juchli, Isabel
  • Liedtke, Claudia
  • Murugiah, Samira
  • Nadler, Jacqueline
  • Obst, Thayze
  • Roth, Jasmin
  • Schlomowitsch, Fiona
  • Schneider, Xiaoye
  • Studerus, Katrin
  • Tynan, Noreen
  • Weishaupt, Dominik
  • Müller, Andreas
  • Fontana, Simone
  • Friedli, Corinne
  • Kuest, Silke
  • Scheuch, Karin
  • Hischier, Denise
  • Bonetti, Nicole
  • Grau, Alexandra
  • Villinger, Jonas
  • Laube, Eva
  • Baumgartner, Philipp
  • Filipovic, Mark
  • Frick, Marcel
  • Montrasio, Giulia
  • Leuenberger, Stefanie
  • Rutz, Franziska
  • Beer, Jürg-Hans
  • Auricchio, Angelo
  • Anesini, Adriana
  • Camporini, Cristina
  • Conte, Giulio
  • Caputo, Maria Luce
  • Regoli, Francois
  • Moccetti, Tiziano
  • Brenner, Roman
  • Altmann, David
  • Gemperle, Michaela
  • Ammann, Peter
  • Firmann, Mathieu
  • Foucras, Sandrine
  • Rime, Martine
  • Hayoz, Daniel
  • Berte, Benjamin
  • Justi, Virgina
  • Kellner-Weldon, Frauke
  • Mehmann, Brigitta
  • Meier, Sonja
  • Roth, Myriam
  • Ruckli-Kaeppeli, Andrea
  • Russi, Ian
  • Schmidt, Kai
  • Young, Mabelle
  • Zbinden, Melanie
  • Kobza, Richard
  • Rigamonti, Elia
  • Cereda, Carlo
  • Cianfoni, Alessandro
  • De Perna, Maria Luisa
  • Frangi-Kultalahti, Jane
  • Melchiorre, Patrizia Assunta Mayer
  • Pin, Anica
  • Terrot, Tatiana
  • Vicari, Luisa
  • Moschovitis, Giorgio
  • Ehret, Georg
  • Gallet, Hervé
  • Guillermet, Elise
  • Lazeyras, Francois
  • Lovblad, Karl-Olof
  • Perret, Patrick
  • Tavel, Philippe
  • Teres, Cheryl
  • Shah, Dipen
  • Lauriers, Nathalie
  • Méan, Marie
  • Salzmann, Sandrine
  • Schläpfer, Jürg
  • Porretta, Alessandra Pia
  • Grêt, Andrea
  • Novak, Jan
  • Vitelli, Sandra
  • Stephan, Frank-Peter
  • Frangi-Kultalahti, Jane
  • Gallino, Augusto
  • Vicari, Luisa
  • Di Valentino, Marcello
  • Aebersold, Helena
  • Foster, Fabienne
  • Schwenkglenks, Matthias
  • Würfel, Jens
  • Altermatt, Anna
  • Amann, Michael
  • Düring, Marco
  • Huber, Petra
  • Ruberte, Esther
  • Sinnecker, Tim
  • Zuber, Vanessa
  • Coslovsky, Michael
  • Benkert, Pascal
  • Dutilh, Gilles
  • Markovic, Milica
  • Neuschwander, Pia
  • Simon, Patrick
  • Schmid, Ramun

publication date

  • December 2022