Standard Modifiable Cardiovascular Risk Factors and Prognostic Outcomes in Non-Valvular Atrial Fibrillation Patients...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Standard Modifiable Cardiovascular Risk Factors (SMurfs) are known to influence atrial fibrillation (AF).
• Limited data exist on the cumulative prognostic impact of SMurfs in Asian non-valvular AF (NVAF) patients on oral anticoagulants (OACs).
• This study addresses the gap by investigating the association between cumulative SMurf burden and outcomes in this specific patient population.

Purpose of the Study:

• To investigate the association between the cumulative burden of SMurfs and the prognosis of Asian NVAF patients receiving OAC therapy.
• To assess the impact of SMurf burden on all-cause mortality and ischemic stroke risk in this cohort.

Main Methods:

• Retrospective cohort study utilizing data from the Tianjin Health and Medical Data Platform (THMDP) from 2015-2020.
• Included 20,782 NVAF patients on OACs, categorized by baseline SMurf count (0, 1-2, or 3-4: hypertension, diabetes, hyperlipidemia, smoking).
• Cox proportional hazards models were used to analyze outcomes, with subgroup and sensitivity analyses performed for robustness.

Main Results:

• A higher SMurf burden was significantly associated with increased all-cause mortality.
• Compared to the SMurf-less group, HRs for all-cause mortality were 1.20 (SMurfs 1-2) and 1.67 (SMurfs 3-4).
• The SMurf (3-4) group showed a significant increased risk for ischemic stroke (HR 1.44), with no significant association for the SMurf (1-2) group. A more pronounced association between SMurfs and mortality was observed in patients with eGFR < 60 mL/min/1.73 m².

Conclusions:

• In Asian NVAF patients on OACs, a greater cumulative burden of SMurfs is linked to a significantly higher risk of all-cause mortality and ischemic stroke.
• These findings underscore the importance of managing cardiovascular risk factors in NVAF patients receiving OACs to improve clinical outcomes.
• The study highlights a pronounced association in patients with reduced kidney function (eGFR < 60).