Related Experiment Video
Updated: May 30, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study
Hilde Espnes1, Tom Wilsgaard1, Jocasta Ball2
1Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Insights
Atrial fibrillation (AF) increases heart failure (HF) risk in both sexes. Women with permanent AF face higher HF risk, while specific risk factors like smoking, hypertension, and obesity vary by sex, impacting mortality.
Area of Science:
- Cardiology
- Public Health
- Sex-Specific Medicine
Background:
- Atrial fibrillation (AF) and heart failure (HF) frequently coexist, significantly affecting patient morbidity and mortality.
- Limited research exists on sex-specific associations between different atrial fibrillation subtypes and heart failure development.
Purpose of the Study:
- To investigate sex-specific links between atrial fibrillation subtypes and subsequent heart failure.
- To identify heart failure risk factors in individuals with atrial fibrillation, considering sex differences.
- To explore the combined impact of atrial fibrillation and heart failure on all-cause mortality.
Main Methods:
- Utilized data from 14,790 women and 13,181 men in the Tromsø Study (1994-2008) with follow-up through 2016.
- Employed Cox regression analysis to calculate Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) for incident AF and HF.
- Analyzed sex-specific risk factors and mortality outcomes associated with AF subtypes and subsequent HF.
Main Results:
- Individuals with AF exhibited an elevated risk of developing HF compared to those without AF, irrespective of sex.
- Women with permanent AF showed a significantly higher relative risk of HF (HR: 10.52) than men (HR: 7.65).
- Shared HF risk factors included smoking; sex-specific factors were hypertension and higher diastolic blood pressure in women, and underweight, obesity, and low alcohol intake in men. All-cause mortality was higher in women with AF and HF, and in men with paroxysmal/persistent AF.
Conclusions:
- All atrial fibrillation subtypes are linked to an increased risk of heart failure.
- Specific risk factors for heart failure in AF patients differ between sexes, with smoking being a common factor.
- The presence of heart failure following atrial fibrillation significantly increases mortality risk for both men and women.
Background:
Atrial fibrillation (AF) and heart failure (HF) often coexist and impact morbidity and mortality. There is limited knowledge on the association of AF subtypes with HF according to sex.
Objectives:
The purpose of this study was to explore sex-specific associations between AF subtypes and subsequent HF, identifying HF risk factors in participants with AF, and exploring the combined impact on mortality.
Methods:
14,790 women and 13,181 men from the Tromsø Study were enrolled between 1994 and 2008 and followed for incident AF and HF through 2016. Cox regression was conducted to provide HRs and 95% CIs.
Results:
Those with AF had higher risk of subsequent HF in both sexes compared to those without AF. Women with permanent AF had higher relative risk of HF than men (HR: 10.52; 95% CI: 8.72-12.70, and HR: 7.65; 95% CI: 6.40-9.15, respectively). Risk factors for HF in participants with AF included smoking in all, higher diastolic blood pressure and hypertension in women, underweight, obesity, and low alcohol consumption in men. All-cause mortality was higher in women with both subtypes (paroxysmal/persistent: HR: 2.10; 95% CI: 1.78-2.48, permanent: HR: 1.40, 95% CI: 1.14-1.72) and in men with paroxysmal/persistent AF (HR: 1.66; 95% CI: 1.40-1.96). Subsequent HF increased risk of mortality in both sexes.
Conclusions:
All AF subtypes were associated with increased risk of HF. Smoking was a shared risk factor, while diastolic blood pressure and hypertension were specific to women, and underweight, obesity, and low alcohol intake were specific to men. Subsequent HF increased mortality risk in all.
More Related Videos
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:22Heart Failure Drugs: β-Blockers
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:28Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...