Family History of Atrial Fibrillation and Risk of Cardiovascular Events A Multicenter Prospective Cohort Study

Pastori, Daniele, Menichelli, Danilo, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Sciacqua, Angela, Violi, Francesco, Pignatelli, Pasquale and Grp, ATHEROAF Study (2020) Family History of Atrial Fibrillation and Risk of Cardiovascular Events A Multicenter Prospective Cohort Study. CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 13 (9). e008477-.

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Official URL: http://dx.doi.org/10.1161/circep.120.008477

Abstract

<h4>Background</h4>To investigate the association between family history of atrial fibrillation (AF) with cardiovascular events (CVEs), major adverse cardiac events (MACE), and cardiovascular mortality.<h4>Methods</h4>Multicenter prospective observational cohort study including 1722 nonvalvular AF patients from February 2008 to August 2019 in Italy. Family history of AF was defined as the presence of AF in a first-degree relative: mother, father, sibling, or children. Primary outcome was a composite of CVEs including fatal/nonfatal ischemic stroke and myocardial infarction, and cardiovascular death. Second, we analyzed the association with major adverse cardiac event.<h4>Results</h4>Mean age was 74.6±9.4 years; 44% of women. Family history of AF was detected in 368 (21.4%) patients, and 3.5% had ≥2 relatives affected by AF. Age of AF onset progressively decreased from patients without family history of AF, compared with those with single and multiple first-degree affected relatives (<i>P</i><0.001). During a mean follow-up of 23.7 months (4606 patients/y) 145 CVEs (3.15%/y), 98 major adverse cardiac event (2.13%/y), and 57 cardiovascular deaths (0.97%/y) occurred. After adjustment for cardiovascular risk factors, family history of AF was associated with a higher risk of CVEs (hazard ratio, 1.524 [95% CI, 1.021-2.274], <i>P</i>=0.039), major adverse cardiac event (hazard ratio, 1.917 [95% CI, 1.207-3.045], <i>P</i>=0.006), and cardiovascular mortality (hazard ratio, 2.008 [95% CI, 1.047-3.851], <i>P</i>=0.036). Subgroup analysis showed that this association was modified by age, sex, and prior ischemic heart disease.<h4>Conclusions</h4>In a cohort of elderly patients with a high atherosclerotic burden, family history of AF is evident in >20% of patients and was associated with an increased risk for CVEs and mortality. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01882114.

Item Type:	Article
Uncontrolled Keywords:	atrial fibrillation, death, familiarity, heart diseases, mortality, myocardial infarction
Depositing User:	Symplectic Admin
Date Deposited:	27 Oct 2020 16:29
Last Modified:	18 Jan 2023 23:25
DOI:	10.1161/CIRCEP.120.008477
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3105302