Long-term risk of adverse outcomes according to atrial fibrillation type
Abstract 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-mo...
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-05688-9 |
| _version_ | 1818284222934155264 |
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| author | Steffen Blum Stefanie Aeschbacher Michael Coslovsky Pascal B. Meyre Philipp Reddiess Peter Ammann Paul Erne Giorgio Moschovitis Marcello Di Valentino Dipen Shah Jürg Schläpfer Rahel Müller Jürg H. Beer Richard Kobza Leo H. Bonati Elisavet Moutzouri Nicolas Rodondi Christine Meyer-Zürn Michael Kühne Christian Sticherling Stefan Osswald David Conen the BEAT-AF and Swiss-AF investigators |
| author_facet | Steffen Blum Stefanie Aeschbacher Michael Coslovsky Pascal B. Meyre Philipp Reddiess Peter Ammann Paul Erne Giorgio Moschovitis Marcello Di Valentino Dipen Shah Jürg Schläpfer Rahel Müller Jürg H. Beer Richard Kobza Leo H. Bonati Elisavet Moutzouri Nicolas Rodondi Christine Meyer-Zürn Michael Kühne Christian Sticherling Stefan Osswald David Conen the BEAT-AF and Swiss-AF investigators |
| author_sort | Steffen Blum |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-13T00:49:23Z |
| format | Article |
| id | doaj.art-d5acc171365d4394bdfc29f4c004cf96 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-13T00:49:23Z |
| publishDate | 2022-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d5acc171365d4394bdfc29f4c004cf962022-12-22T00:04:57ZengNature PortfolioScientific Reports2045-23222022-02-011211810.1038/s41598-022-05688-9Long-term risk of adverse outcomes according to atrial fibrillation typeSteffen Blum0Stefanie Aeschbacher1Michael Coslovsky2Pascal B. Meyre3Philipp Reddiess4Peter Ammann5Paul Erne6Giorgio Moschovitis7Marcello Di Valentino8Dipen Shah9Jürg Schläpfer10Rahel Müller11Jürg H. Beer12Richard Kobza13Leo H. Bonati14Elisavet Moutzouri15Nicolas Rodondi16Christine Meyer-Zürn17Michael Kühne18Christian Sticherling19Stefan Osswald20David Conen21the BEAT-AF and Swiss-AF investigatorsDivision of Cardiology, Department of Medicine, University Hospital BaselDivision of Cardiology, Department of Medicine, University Hospital BaselCardiovascular Research Institute Basel, University Hospital BaselDivision of Cardiology, Department of Medicine, University Hospital BaselDivision of Cardiology, Department of Medicine, University Hospital BaselDivision of Cardiology, Kantonsspital St. GallenLaboratory for Signal Transduction, Department of Biomedicine, University of BaselEnte Ospedaliero Cantonale LuganoEnte Ospedaliero Cantonale BellinzonaUniversity Hospital GenevaUniversity Hospital LausanneCardiovascular Research Institute Basel, University Hospital BaselKantonspital BadenLuzerner KantonsspitalDepartment of Neurology and Stroke Center, University Hospital BaselInstitute of Primary Health Care (BIHAM), University of BernInstitute of Primary Health Care (BIHAM), University of BernDivision of Cardiology, Department of Medicine, University Hospital BaselDivision of Cardiology, Department of Medicine, University Hospital BaselDivision of Cardiology, Department of Medicine, University Hospital BaselDivision of Cardiology, Department of Medicine, University Hospital BaselCardiovascular Research Institute Basel, University Hospital BaselAbstract 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.https://doi.org/10.1038/s41598-022-05688-9 |
| spellingShingle | Steffen Blum Stefanie Aeschbacher Michael Coslovsky Pascal B. Meyre Philipp Reddiess Peter Ammann Paul Erne Giorgio Moschovitis Marcello Di Valentino Dipen Shah Jürg Schläpfer Rahel Müller Jürg H. Beer Richard Kobza Leo H. Bonati Elisavet Moutzouri Nicolas Rodondi Christine Meyer-Zürn Michael Kühne Christian Sticherling Stefan Osswald David Conen the BEAT-AF and Swiss-AF investigators Long-term risk of adverse outcomes according to atrial fibrillation type Scientific Reports |
| title | Long-term risk of adverse outcomes according to atrial fibrillation type |
| title_full | Long-term risk of adverse outcomes according to atrial fibrillation type |
| title_fullStr | Long-term risk of adverse outcomes according to atrial fibrillation type |
| title_full_unstemmed | Long-term risk of adverse outcomes according to atrial fibrillation type |
| title_short | Long-term risk of adverse outcomes according to atrial fibrillation type |
| title_sort | long term risk of adverse outcomes according to atrial fibrillation type |
| url | https://doi.org/10.1038/s41598-022-05688-9 |
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