Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors: an RE-LY AF registry analysis
Kloosterman, Mariëlle; Oldgren, Jonas; Conen, David; Wong, Jorge A; Connolly, Stuart J; Avezum, Alvaro; Yusuf, Salim; Ezekowitz, Michael D; Wallentin, Lars; Ntep-Gweth, Marie; Joseph, Philip; Barrett, Tyler W; Tanosmsup, Supachai; McIntyre, William F; Lee, Shun Fu; Parkash, Ratika; Amit, Guy; Grinvalds, Alex; Gelder, Isabelle C Van; Healey, Jeff S.
Europace
; 22(6): 870-877, June., 2020. tab., ilus.
Artículo
en Inglés
| SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1123436
ABSTRACT Aims Data on patient characteristics, prevalence, and outcomes of atrial fibrillation (AF) patients without traditional risk factors, often labelled 'lone AF', are sparse. METHODS AND
RESULTS:
The RE-LY AF registry included 15 400 individuals who presented to emergency departments with AF in 47 countries. This analysis focused on patients without traditional risk factors, including age ≥60 years, hypertension, coronary artery disease, heart failure, left ventricular hypertrophy, congenital heart disease, pulmonary disease, valve heart disease, hyperthyroidism, and prior cardiac surgery. Patients without traditional risk factors were compared with age- and region-matched controls with traditional risk factors (13 fashion). In 796 (5%) patients, no traditional risk factors were present. However, 98% (779/796) had less-established or borderline risk factors, including borderline hypertension (130-140/80-90 mmHg; 47%), chronic kidney disease (eGFR < 60 mL/min; 57%), obesity (body mass index > 30; 19%), diabetes (5%), excessive alcohol intake (>14 units/week; 4%), and smoking (25%). Compared with patients with traditional risk factors (n = 2388), patients without traditional risk factors were more often men (74% vs. 59%, P < 0.001) had paroxysmal AF (55% vs. 37%, P < 0.001) and less AF persistence after 1 year (21% vs. 49%, P < 0.001). Furthermore, 1-year stroke occurrence rate (0.6% vs. 2.0%, P = 0.013) and heart failure hospitalizations (0.9% vs. 12.5%, P < 0.001) were lower. However, risk of AF-related re-hospitalization was similar (18% vs. 21%, P = 0.09).CONCLUSION:
Almost all patients without traditionally defined AF risk factors have less-established or borderline risk factors. These patients have a favourable 1-year prognosis, but risk of AF-related re-hospitalization remains high. Greater emphasis should be placed on recognition and management of less-established or borderline risk factors.
Biblioteca responsable:
BR79.1
Ubicación: BR79.1
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