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

Issued Date

2020-06-01

Resource Type

Article

ISSN

15322092
10995129

DOI

10.1093/europace/euz360

Other identifier(s)

2-s2.0-85086051549

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Europace. Vol.22, No.6 (2020), 870-877

Suggested Citation

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 Characteristics and outcomes of atrial fibrillation in patients without traditional risk factors: An RE-LY AF registry analysis. Europace. Vol.22, No.6 (2020), 870-877. doi:10.1093/europace/euz360 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/58147

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Title

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

Author(s)

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

Other Contributor(s)

Population Health Research Institute, Ontario
 Hopital Central de Yaounde
 Vanderbilt University Medical Center
 Instituto Dante Pazzanese de Cardiologia
 Akademiska Sjukhuset
 Mahidol University
 Lankenau Institute for Medical Research
 University of Groningen, University Medical Center Groningen
 QEII Health Sciences Centre

Abstract

© 2019 Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. 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.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/58147

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Scopus 2020