Factors Associated with Progression of Atrial Fibrillation and Impact on All-Cause Mortality in a Cohort of European Patients



Vitolo, Marco, Proietti, Marco ORCID: 0000-0003-1452-2478, Imberti, Jacopo F, Bonini, Niccolo, Romiti, Giulio Francesco, Mei, Davide A, Malavasi, Vincenzo L, Diemberger, Igor, Fauchier, Laurent, Marin, Francisco
et al (show 5 more authors) (2023) Factors Associated with Progression of Atrial Fibrillation and Impact on All-Cause Mortality in a Cohort of European Patients. JOURNAL OF CLINICAL MEDICINE, 12 (3). 768-.

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Abstract

<h4>Background</h4>Paroxysmal atrial fibrillation (AF) may often progress towards more sustained forms of the arrhythmia, but further research is needed on the factors associated with this clinical course.<h4>Methods</h4>We analyzed patients enrolled in a prospective cohort study of AF patients. Patients with paroxysmal AF at baseline or first-detected AF (with successful cardioversion) were included. According to rhythm status at 1 year, patients were stratified into: (i) No AF progression and (ii) AF progression. All-cause death was the primary outcome.<h4>Results</h4>A total of 2688 patients were included (median age 67 years, interquartile range 60-75, females 44.7%). At 1-year of follow-up, 2094 (77.9%) patients showed no AF progression, while 594 (22.1%) developed persistent or permanent AF. On multivariable logistic regression analysis, no physical activity (odds ratio [OR] 1.35, 95% CI 1.02-1.78), valvular heart disease (OR 1.63, 95% CI 1.23-2.15), left atrial diameter (OR 1.03, 95% CI 1.01-1.05), or left ventricular ejection fraction (OR 0.98, 95% CI 0.97-1.00) were independently associated with AF progression at 1 year. After the assessment at 1 year, the patients were followed for an extended follow-up of 371 days, and those with AF progression were independently associated with a higher risk for all-cause death (adjusted hazard ratio 1.77, 95% CI 1.09-2.89) compared to no-AF-progression patients.<h4>Conclusions</h4>In a contemporary cohort of AF patients, a substantial proportion of patients presenting with paroxysmal or first-detected AF showed progression of the AF pattern within 1 year, and clinical factors related to cardiac remodeling were associated with progression. AF progression was associated with an increased risk of all-cause mortality.

Item Type: Article
Uncontrolled Keywords: atrial fibrillation, atrial fibrillation type, remodeling, progression, outcomes, death, registry
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 18 May 2023 13:05
Last Modified: 18 May 2023 13:05
DOI: 10.3390/jcm12030768
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3170492