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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Newly diagnosed atrial fibrillation is an independent factor for future major adverse cardiovascular events
Chen-Yu Li1, Chia-Pin Lin2, Yu-Sheng Lin2
1Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taipei, Taiwan.
Insights
Newly diagnosed atrial fibrillation (AF) independently increases the risk of major adverse cardiac events (MACE) and mortality. Even without other risk factors, new AF significantly elevates MACE risk.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Atrial fibrillation (AF) is a common cardiac arrhythmia linked to cardiovascular (CV) events.
- The independent impact of newly diagnosed AF on future major adverse cardiac events (MACE) remains unclear, particularly in patients without prior CV history.
Purpose of the Study:
- To investigate whether newly diagnosed AF is an independent predictor of future MACE.
- To assess the association between newly diagnosed AF and mortality.
- To evaluate the influence of co-existing CV risk factors on MACE in patients with new-onset AF.
Main Methods:
- Retrospective cohort study using the National Health Insurance Research Database in Taiwan (2006-2010).
- Inclusion of 713,288 adults, excluding those with prior MACE.
- Propensity score matching for demographic and clinical variables, followed by Cox proportional hazard models to estimate MACE risk.
Main Results:
- Newly diagnosed AF was independently associated with increased MACE (HR: 3.11-3.51) and mortality.
- Patients with newly diagnosed AF and no other CV risk factors had an 8.45-fold increased risk of future MACE compared to healthy adults.
- A higher number of co-existing CV risk factors amplified the rate of future CV events in AF patients.
Conclusions:
- Newly diagnosed AF is an independent risk factor for future cardiovascular events and mortality, even after adjusting for common CV risk factors.
- The presence of additional cardiovascular risk factors exacerbates the adverse outcomes associated with new-onset AF.
Objectives:
This study aims to investigate the impact of newly diagnosed atrial fibrillation (AF) on future major adverse cardiac events (MACE). AF is the most common form of cardiac arrhythmia and is associated with several other cardiovascular (CV) events. Little is known about whether newly diagnosed AF is an independent factor for future MACE, especially in patients without such a history.
Methods And Results:
We evaluated data from the National Health Insurance Research Database, which represented a retrospective cohort of 713,288 adults in Taiwan from 2006 to 2010. Individuals with previous MACE were excluded. Newly diagnosed AF patients were identified by assigning International Classification of Diseases codes. Propensity score matching adjusted for gender, age, hypertension, diabetes mellitus and dyslipidemia. Cox proportional hazard models estimated future MACE ratios. We compared a total of 3,737 patients with newly diagnosed AF and 704,225 patients without. After matching, there was no difference in baseline demographic characteristics in patients across newly diagnosed AF and non-AF groups. The result showed that newly diagnosed AF in multivariate analysis were associated with increased incidents of MACE (hazard ratio: 3.11-3.51 in different models) and mortality. Newly diagnosed AF without other CV risk factors had 8.45 times the risk of developing future MACE than healthy adults. The more associated CV risk factors in addition to AF, the increased rate of future CV events.
Conclusions:
Newly diagnosed AF is an independent factor that leads to future CV events after gender, age, hypertension, diabetes mellitus and dyslipidemia matching. AF is associated with a higher mortality rate.
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