Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors: An RE-LY AF registry analysis

Mariëlle Kloosterman, Jonas Oldgren, David Conen, Jorge A. Wong, Stuart J. Connolly, Alvaro Avezum, Salim Yusuf, Michael D. Ezekowitz, Lars Wallentin, Marie Ntep-Gweth, Philip Joseph, Tyler W. Barrett, Supachai Tanosmsup, William F. McIntyre, Shun Fu Lee, Ratika Parkash, Guy Amit, Alex Grinvalds, Isabelle C. Van Gelder, Jeff S. Healey

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Aims: Data on patient characteristics, prevalence, and outcomes of atrial fibrillation (AF) patients without traditional risk factors, often labelled 'lone AF', are sparse. Methods and results: The RE-LY AF registry included 15 400 individuals who presented to emergency departments with AF in 47 countries. This analysis focused on patients without traditional risk factors, including age ≥60 years, hypertension, coronary artery disease, heart failure, left ventricular hypertrophy, congenital heart disease, pulmonary disease, valve heart disease, hyperthyroidism, and prior cardiac surgery. Patients without traditional risk factors were compared with age- and region-matched controls with traditional risk factors (1:3 fashion). In 796 (5%) patients, no traditional risk factors were present. However, 98% (779/796) had less-established or borderline risk factors, including borderline hypertension (130-140/80-90 mmHg; 47%), chronic kidney disease (eGFR < 60 mL/min; 57%), obesity (body mass index > 30; 19%), diabetes (5%), excessive alcohol intake (>14 units/week; 4%), and smoking (25%). Compared with patients with traditional risk factors (n = 2388), patients without traditional risk factors were more often men (74% vs. 59%, P < 0.001) had paroxysmal AF (55% vs. 37%, P < 0.001) and less AF persistence after 1 year (21% vs. 49%, P < 0.001). Furthermore, 1-year stroke occurrence rate (0.6% vs. 2.0%, P = 0.013) and heart failure hospitalizations (0.9% vs. 12.5%, P < 0.001) were lower. However, risk of AF-related re-hospitalization was similar (18% vs. 21%, P = 0.09). Conclusion: Almost all patients without traditionally defined AF risk factors have less-established or borderline risk factors. These patients have a favourable 1-year prognosis, but risk of AF-related re-hospitalization remains high. Greater emphasis should be placed on recognition and management of less-established or borderline risk factors.

Original languageEnglish
Pages (from-to)870-877
Number of pages8
JournalEuropace
Volume22
Issue number6
DOIs
StatePublished - 1 Jun 2020
Externally publishedYes

Keywords

  • Atrial fibrillation hospitalization
  • Borderline risk factors
  • Less-established risk factors
  • Lone atrial fibrillation
  • Registry
  • Substrate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint

Dive into the research topics of 'Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors: An RE-LY AF registry analysis'. Together they form a unique fingerprint.

Cite this