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Published on: February 28, 2012
Long-term outcomes of secondary atrial fibrillation in the community: the Framingham Heart Study
Steven A Lubitz1, Xiaoyan Yin2, Michiel Rienstra2
1From Cardiovascular Research Center (S.A.L., P.T.E.) and Cardiac Arrhythmia Service (S.A.L., P.T.E.), Massachusetts General Hospital, Boston; Boston University and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA (X.Y., J.W.M., D.L., R.S.V., M.G.L., E.J.B.); Department of Cardiology, University of Groningen, University Medical Center Groningen, The Netherlands (M.R.); Department of General and Interventional Cardiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany (R.B.S.); Pulmonary Center and Section of Pulmonary and Critical Care Medicine (A.J.W.), Section of Cardiovascular Medicine (J.W.M., R.S.V., E.J.B.), and Section of Preventive Medicine (R.S.V., E.J.B.), Department of Medicine, Boston University School of Medicine, MA; Department of Medicine, Boston University Medical Center, MA (F.R.); Departments of Medicine and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester (D.D.M.); Sutter Medical Group, Sacramento, CA (T.M.T.); Population Sciences Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (D.L.); Department of Mathematics and Statistics, Boston University, MA (M.G.L.); and Departments of Biostatistics (M.G.L.) and Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA. slubitz@mgh.harvard.edu.
Atrial fibrillation (AF) recurs in most patients, even when triggered by secondary conditions. Long-term risks for stroke and death remain similar, though heart failure risk is reduced in these cases.
Area of Science:
- Cardiology
- Clinical Medicine
- Epidemiology
Background:
- Atrial fibrillation (AF) can present as an isolated event, often triggered by secondary, reversible conditions.
- Limited data exists on long-term outcomes for AF diagnosed during these secondary precipitants.
Purpose of the Study:
- To investigate the long-term outcomes of atrial fibrillation (AF) based on whether it was diagnosed during a secondary precipitating event.
- To compare AF recurrence, stroke risk, mortality, and heart failure risk between patients with and without secondary precipitants.
Main Methods:
- Analysis of 1409 Framingham Heart Study participants with new-onset AF.
- Categorization of AF episodes based on the presence or absence of secondary precipitants (e.g., surgery, infection, myocardial infarction).
- Long-term follow-up to assess AF recurrence, stroke, mortality, and heart failure.
Main Results:
- AF recurred in a majority of individuals, regardless of secondary precipitants.
- Long-term AF recurrence rates were lower when AF was diagnosed during a secondary precipitant (HR, 0.65).
- Stroke and mortality risks were similar, but heart failure risk was reduced in patients with secondary AF precipitants (HR, 0.74).
Conclusions:
- Atrial fibrillation recurs frequently, even in cases initially diagnosed during secondary precipitants.
- Long-term risks for stroke and mortality following AF are comparable between patients with and without secondary precipitants.
- Further research is needed to determine if enhanced surveillance or management can mitigate morbidity in patients with reversible AF triggers.
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