Cardiovascular health and risks of atrial fibrillation and its prognosis

Atrial fibrillation (AF) is the most common cardiac arrhythmia around the world with an increased risk of a broad spectrum of adverse comorbidities and death. Whether cardiovascular health (CVH) is associated with AF development remains unclear.

238,420 participants without cardiovascular disease at baseline were selected from the UK Biobank study cohort from 2006 to 2010. CVH was defined based on "Life's Essential 8″ scores. Sex-specific multi-state Markov and flexible parametric survival models were used to estimate the hazard ratio (HR) and 95 % confidence intervals (95 % CI) for the associations of CVH with incident AF and its prognosis.

In fully-adjusted models, CVH is significantly associated with a reduced risk of incident AF among both men and women, after accounting for the potential impact of death. Among AF patients without other evaluated diseases, a higher CVH score was generally linked with a reduced risk of death in both sexes. Among AF patients with incident prognostic diseases, only CVH associated with death following heart failure (0.78, 0.63-0.97) was observed among men, whereas CVH was significantly associated with death following coronary heart disease (0.80, 0.69-0.93), stroke (0.73, 0.61-0.89) and dementia (0.79, 0.71-1.03) among women.

We found significant associations between CVH and the risk reduction of incident AF and its prognostic outcomes, with these associations being more pronounced among women. Findings suggest a potential of screening CVH for both primary prevention of new-onset AF and the secondary prevention to improve AF prognosis.