Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis
Objective: To quantify the association between atrial fibrillation and cardiovascular disease, renal disease, and death. Design: Systematic review and meta-analysis. Data sources: Medline and Embase. Eligibility criteria: Cohort studies examining the association between atrial fibrillation and ca...
| Principais autores: | , , , , , |
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| Outros Autores: | |
| Formato: | Artigo |
| Idioma: | en_US |
| Publicado em: |
BMJ Publishing Group
2017
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| Acesso em linha: | http://hdl.handle.net/1721.1/108109 https://orcid.org/0000-0002-6609-8712 |
| _version_ | 1826211653137465344 |
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| author | Odutayo, Ayodele Wong, Christopher X Hopewell, Sally Altman, Douglas G Emdin, Connor A Hsiao, Allan |
| author2 | Massachusetts Institute of Technology. Department of Economics |
| author_facet | Massachusetts Institute of Technology. Department of Economics Odutayo, Ayodele Wong, Christopher X Hopewell, Sally Altman, Douglas G Emdin, Connor A Hsiao, Allan |
| author_sort | Odutayo, Ayodele |
| collection | MIT |
| description | Objective: To quantify the association between atrial fibrillation and cardiovascular disease, renal disease, and death.
Design: Systematic review and meta-analysis.
Data sources: Medline and Embase.
Eligibility criteria: Cohort studies examining the association between atrial fibrillation and cardiovascular disease, renal disease, and death. Two reviewers independently extracted study characteristics and the relative risk of outcomes associated with atrial fibrillation: specifically, all cause mortality, cardiovascular mortality, major cardiovascular events, any stroke, ischaemic stroke, haemorrhagic stroke, ischaemic heart disease, sudden cardiac death, congestive heart failure, chronic kidney disease, and peripheral arterial disease. Estimates were pooled with inverse variance weighted random effects meta-analysis.
Results: 104 eligible cohort studies involving 9 686 513 participants (587 867 with atrial fibrillation) were identified. Atrial fibrillation was associated with an increased risk of all cause mortality (relative risk 1.46, 95% confidence interval 1.39 to 1.54), cardiovascular mortality (2.03, 1.79 to 2.30), major cardiovascular events (1.96, 1.53 to 2.51), stroke (2.42, 2.17 to 2.71), ischaemic stroke (2.33, 1.84 to 2.94), ischaemic heart disease (1.61, 1.38 to 1.87), sudden cardiac death (1.88, 1.36 to 2.60), heart failure (4.99, 3.04 to 8.22), chronic kidney disease (1.64, 1.41 to 1.91), and peripheral arterial disease (1.31, 1.19 to 1.45) but not haemorrhagic stroke (2.00, 0.67 to 5.96). Among the outcomes examined, the highest absolute risk increase was for heart failure. Associations between atrial fibrillation and included outcomes were broadly consistent across subgroups and in sensitivity analyses.
Conclusions: Atrial fibrillation is associated with an increased risk of death and an increased risk of cardiovascular and renal disease. Interventions aimed at reducing outcomes beyond stroke are warranted in patients with atrial fibrillation. |
| first_indexed | 2024-09-23T15:09:24Z |
| format | Article |
| id | mit-1721.1/108109 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T15:09:24Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | mit-1721.1/1081092022-09-29T13:04:59Z Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis Odutayo, Ayodele Wong, Christopher X Hopewell, Sally Altman, Douglas G Emdin, Connor A Hsiao, Allan Massachusetts Institute of Technology. Department of Economics Hsiao, Allan Objective: To quantify the association between atrial fibrillation and cardiovascular disease, renal disease, and death. Design: Systematic review and meta-analysis. Data sources: Medline and Embase. Eligibility criteria: Cohort studies examining the association between atrial fibrillation and cardiovascular disease, renal disease, and death. Two reviewers independently extracted study characteristics and the relative risk of outcomes associated with atrial fibrillation: specifically, all cause mortality, cardiovascular mortality, major cardiovascular events, any stroke, ischaemic stroke, haemorrhagic stroke, ischaemic heart disease, sudden cardiac death, congestive heart failure, chronic kidney disease, and peripheral arterial disease. Estimates were pooled with inverse variance weighted random effects meta-analysis. Results: 104 eligible cohort studies involving 9 686 513 participants (587 867 with atrial fibrillation) were identified. Atrial fibrillation was associated with an increased risk of all cause mortality (relative risk 1.46, 95% confidence interval 1.39 to 1.54), cardiovascular mortality (2.03, 1.79 to 2.30), major cardiovascular events (1.96, 1.53 to 2.51), stroke (2.42, 2.17 to 2.71), ischaemic stroke (2.33, 1.84 to 2.94), ischaemic heart disease (1.61, 1.38 to 1.87), sudden cardiac death (1.88, 1.36 to 2.60), heart failure (4.99, 3.04 to 8.22), chronic kidney disease (1.64, 1.41 to 1.91), and peripheral arterial disease (1.31, 1.19 to 1.45) but not haemorrhagic stroke (2.00, 0.67 to 5.96). Among the outcomes examined, the highest absolute risk increase was for heart failure. Associations between atrial fibrillation and included outcomes were broadly consistent across subgroups and in sensitivity analyses. Conclusions: Atrial fibrillation is associated with an increased risk of death and an increased risk of cardiovascular and renal disease. Interventions aimed at reducing outcomes beyond stroke are warranted in patients with atrial fibrillation. 2017-04-13T16:24:56Z 2017-04-13T16:24:56Z 2016-09 2016-08 Article http://purl.org/eprint/type/JournalArticle 0959-8138 1468-5833 http://hdl.handle.net/1721.1/108109 Odutayo, Ayodele, et al. “Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis,” BMJ, (2016): 354. © 2016 BMJ Publishing Group Ltd. https://orcid.org/0000-0002-6609-8712 en_US http://dx.doi.org/10.1136/bmj.i4482 BMJ Creative Commons Attribution-NonCommercial 3.0 Unported licence http://creativecommons.org/licenses/by-nc/3.0/ application/pdf BMJ Publishing Group BMJ |
| spellingShingle | Odutayo, Ayodele Wong, Christopher X Hopewell, Sally Altman, Douglas G Emdin, Connor A Hsiao, Allan Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis |
| title | Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis |
| title_full | Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis |
| title_fullStr | Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis |
| title_full_unstemmed | Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis |
| title_short | Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis |
| title_sort | atrial fibrillation and risks of cardiovascular disease renal disease and death systematic review and meta analysis |
| url | http://hdl.handle.net/1721.1/108109 https://orcid.org/0000-0002-6609-8712 |
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