Related Experiment Video
Updated: Jul 18, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
New-onset atrial fibrillation and chronic coronary syndrome in the CLARIFY registry
Alexandre Gautier1,2, Fabien Picard2,3, Gregory Ducrocq1,2
1Department of Cardiology, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, French Alliance for Cardiovascular Trials, INSERM U1148, Laboratory for Vascular Translational Science, 46 rue Henri Huchard, 75018 Paris, France.
Insights
New-onset atrial fibrillation (NOAF) is common in chronic coronary syndromes (CCS) patients and significantly increases cardiovascular risks. Early detection and intervention strategies for NOAF in CCS are crucial for improving patient prognosis.
Area of Science:
- Cardiology
- Epidemiology
- Clinical Research
Background:
- Limited data exist on new-onset atrial fibrillation (NOAF) in patients with chronic coronary syndromes (CCS).
- Understanding NOAF incidence, predictors, and outcomes in CCS is vital for patient management.
Purpose of the Study:
- To determine the incidence, identify predictors, and assess the impact of NOAF on cardiovascular outcomes in CCS patients.
- To analyze data from the international CLARIFY registry for insights into NOAF in stable coronary artery disease.
Main Methods:
- Utilized data from 29,001 CCS outpatients in the CLARIFY registry across 45 countries.
- Compared patients who developed NOAF during 5-year follow-up with those remaining in sinus rhythm.
- Employed statistical analysis to identify independent predictors and assess outcome risks.
Main Results:
- The incidence rate of NOAF was 1.12 per 100 patient-years (5.0% cumulative incidence at 5 years).
- Independent predictors included older age, higher BMI, lower eGFR, Caucasian ethnicity, alcohol intake, and reduced LVEF.
- NOAF significantly increased risks for CV death, MI, stroke, all-cause death, heart failure hospitalization, and major bleeding.
Conclusions:
- NOAF is prevalent in CCS patients and strongly linked to adverse cardiovascular outcomes.
- Further research is warranted on intensive preventive measures and systematic AF screening to improve prognosis in this population.
Background And Aims:
Data on new-onset atrial fibrillation (NOAF) in patients with chronic coronary syndromes (CCS) are scarce. This study aims to describe the incidence, predictors, and impact on cardiovascular (CV) outcomes of NOAF in CCS patients.
Methods:
Data from the international (45 countries) CLARIFY registry (prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) were used. Among 29 001 CCS outpatients without previously reported AF at baseline, patients with at least one episode of AF/flutter diagnosed during 5-year follow-up were compared with patients in sinus rhythm throughout the study.
Results:
The incidence rate of NOAF was 1.12 [95% confidence interval (CI) 1.06-1.18] per 100 patient-years (cumulative incidence at 5 years: 5.0%). Independent predictors of NOAF were increasing age, increasing body mass index, low estimated glomerular filtration rate, Caucasian ethnicity, alcohol intake, and low left ventricular ejection fraction, while high triglycerides were associated with lower incidence. New-onset atrial fibrillation was associated with a substantial increase in the risk of adverse outcomes, with adjusted hazard ratios of 2.01 (95% CI 1.61-2.52) for the composite of CV death, non-fatal myocardial infarction, or non-fatal stroke, 2.61 (95% CI 2.04-3.34) for CV death, 1.64 (95% CI 1.07-2.50) for non-fatal myocardial infarction, 2.27 (95% CI 1.85-2.78) for all-cause death, 8.44 (95% CI 7.05-10.10) for hospitalization for heart failure, and 4.46 (95% CI 2.85-6.99) for major bleeding.
Conclusions:
Among CCS patients, NOAF is common and is strongly associated with worse outcomes. Whether more intensive preventive measures and more systematic screening for AF would improve prognosis in this population deserves further investigation.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
01:26Acute Coronary Syndrome V: Nursing Management