Mortality, Hospitalization, and Cardiac Interventions in Patients With Atrial Fibrillation Aged <65 Years

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The clinical course and long-term outcomes for patients under 65 with atrial fibrillation (AF) are not well-understood.
• Understanding the burden of risk factors (RFs) and comorbidities in younger AF patients is essential for effective management.

Purpose of the Study:

• To investigate the risk factor burden, clinical course, and long-term outcomes in patients with atrial fibrillation (AF) younger than 65 years.
• To compare the mortality risk of AF patients under 65 with a matched cohort without AF.

Main Methods:

• A retrospective analysis of adult AF patients (n=67,221) evaluated between 2010-2019.
• Utilized electronic health records and administrative data to identify risk factors, comorbidities, and outcomes.
• Compared mortality in AF patients <65 years to a large cohort (n=918,073) without AF.

Main Results:

• Nearly a quarter of AF patients were under 65, with substantial cardiovascular risk factors and comorbidities.
• Patients with AF <65 years experienced significantly higher all-cause mortality compared to those without AF.
• Increased risk of hospitalization for myocardial infarction, heart failure, and stroke was observed in younger AF patients, with age-related interactions for heart failure and hypertension.

Conclusions:

• Patients with AF younger than 65 have a significant comorbidity burden and considerable long-term mortality risk.
• These patients face a substantially increased risk of hospitalization for major cardiovascular events.
• Aggressive evaluation and management of risk factors and comorbidities are warranted for younger AF patients.