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Association between cardiometabolic comorbidity and mortality in patients with atrial fibrillation

Zhaojie Dong1,2, Chao Jiang3, Liu He3

  • 1Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

BMC Cardiovascular Disorders
|April 30, 2025
PubMed

Insights

The number of cardiometabolic conditions significantly increases mortality risk in atrial fibrillation (AF) patients. Effective management of these comorbidities is crucial for improving prognosis in AF patients.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Public Health

Background:

  • Atrial fibrillation (AF) patients frequently have cardiometabolic comorbidities.
  • The impact of cardiometabolic comorbidity type and number on AF prognosis is not well understood.

Purpose of the Study:

  • To investigate the association between the type and number of cardiometabolic comorbidities and mortality in AF patients.
  • To identify specific comorbidities that most significantly affect AF patient outcomes.

Main Methods:

  • Analysis of 23,838 AF patients from the Chinese Atrial Fibrillation Registry (China-AF) Study (August 2011-December 2018).
  • Utilized Cox proportional hazard models to assess the relationship between comorbidities and all-cause/cardiovascular mortality.
  • Follow-up duration averaged 4.07 ± 1.96 years.

Main Results:

  • Mortality was higher in AF patients with cardiometabolic conditions compared to those without.
  • Heart failure presented the highest risk for all-cause mortality (HR 1.92), followed by thromboembolism, diabetes mellitus, and vascular diseases.
  • Increased number of comorbidities correlated with higher mortality: HRs of 1.21, 1.71, 2.55, and 3.39 for 1, 2, 3, and ≥4 comorbidities, respectively. Hypertension showed no significant association.

Conclusions:

  • A greater number of cardiometabolic comorbidities is directly linked to increased mortality in AF patients.
  • Intensified management of cardiometabolic conditions is essential for reducing mortality in the AF population.
Abstract

Keywords:
Atrial fibrillationCardiometabolicMortalityMultimorbidity

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