TY - JOUR
T1 - Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors
T2 - An RE-LY AF registry analysis
AU - Kloosterman, Mariëlle
AU - Oldgren, Jonas
AU - Conen, David
AU - Wong, Jorge A.
AU - Connolly, Stuart J.
AU - Avezum, Alvaro
AU - Yusuf, Salim
AU - Ezekowitz, Michael D.
AU - Wallentin, Lars
AU - Ntep-Gweth, Marie
AU - Joseph, Philip
AU - Barrett, Tyler W.
AU - Tanosmsup, Supachai
AU - McIntyre, William F.
AU - Lee, Shun Fu
AU - Parkash, Ratika
AU - Amit, Guy
AU - Grinvalds, Alex
AU - Van Gelder, Isabelle C.
AU - Healey, Jeff S.
N1 - Publisher Copyright:
© 2019 Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2020. For permissions, please email: [email protected].
PY - 2020/6/1
Y1 - 2020/6/1
N2 - 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.
AB - 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.
KW - Atrial fibrillation hospitalization
KW - Borderline risk factors
KW - Less-established risk factors
KW - Lone atrial fibrillation
KW - Registry
KW - Substrate
UR - http://www.scopus.com/inward/record.url?scp=85086051549&partnerID=8YFLogxK
U2 - 10.1093/europace/euz360
DO - 10.1093/europace/euz360
M3 - Article
C2 - 32215649
AN - SCOPUS:85086051549
SN - 1099-5129
VL - 22
SP - 870
EP - 877
JO - Europace
JF - Europace
IS - 6
ER -
