Independent Risk Factors for Atrial Fibrillation in a Population-Based Cohort

Abstract Background It is important to determine the risk factors that predispose elderly subjects from the general population for symptomatic atrial fibrillation and atrial flutter (AF/AFl), but population-based data for silent AF (SAF) are limited. Aim To study risk factors for symptomatic AF and SAF in a general population screen for subjects age ≥65 where continuous monitoring was performed up to 30 days with a vest-based monitor. Methods The NOMED-AF study was a cross-sectional study based on a representative population sample (n=3014; mean age 77.5±7.9 years; F=1479). In 680 subjects AF/AFl (including 279 with SAF) was diagnosed. Independent risk factors for AF/AFl and SAF were determine on weighted data using multiple logistic regression. Results The independent risk factors for AF/AFl and SAF are summarised in the Table. There are nine independent risk factors for AF/AFl and eight for SAF. Revascularization and obesity were independently associated with patients with (symptomatic) AF/AFl, and CKD was associated with SAF. Other risk factors are common for AF/AFl and SAF. Conclusions AF/AFl and SAF have slightly different associated clinical risk factors in this representative population sample aged ≥65 years. This may facilitated targeted screening programmes for high risk subgroups, particularly for SAF. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The research has received funding from the National Centre for Research and Development under grant agreement (STRATEGMED2/269343/18/NCBR/2016)

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Factors associated with 90-day acute ischemic stroke in patients ≥70 years old with total hip arthroplasty for hip fracture

BMC Geriatrics ◽

10.1186/s12877-021-02728-3 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Rui He ◽

Guoyou Wang ◽

Ting Li ◽

Huarui Shen ◽

LijuanZhang

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Logistic Regression ◽

Ischemic Stroke ◽

Hip Fracture ◽

Total Hip Arthroplasty ◽

Older Age ◽

Factors Associated ◽

Independent Risk Factors ◽

D Dimer

Abstract Background Postoperative ischemic stroke is a devastating complication following total hip arthroplasty (THA). The purpose of the current study was to investigate the incidence of postoperative acute ischemic stroke (AIS) in patients ≥70 years old with THA for hip fracture after 90 days and independent risk factors associated with 90-day AIS. Methods A multicenter retrospective study was conducted, patients ≥70 years old with THA for hip fracture under general anesthesia were included from February 2017 to March 2020. Patients with AIS within 90 days after THA were identified as AIS group; patients with no AIS were identified as no AIS group. The baseline characteristics and risk factors were collected, multivariable logistic regression was used to identify independent risk factors of 90-dayAIS. Results: 2517 patients (mean age 76.18 ± 6.01) were eligible for inclusion in the study. 2.50% (63/2517) of patients had 90-day AIS. Compared with no AIS, older age, diabetes, hyperlipidemia, atrial fibrillation (AF) and higher D-dimer value were more likely in patients with AIS (P < 0.05), and anticoagulant use was fewer in patients with AIS. ROC curve analysis showed that the optimal cut point of D-dimer for AIS was D-dimer≥4.12 μg/ml. Multivariate logistic regression analysis showed that D-dimer≥4.12 μg/ml [adjusted odds ratio (aOR), 4.44; confidence interval (CI), 2.50–7.72; P < 0.001], older age (aOR, 1.08; 95%CI, 1.03–1.12; P < 0.001), hyperlipidemia (aOR, 2.28; 95%CI, 1.25–4.16; P = 0.007), atrial fibrillation (aOR, 5.84; 95% CI, 1.08–15.68; P = 0.001), and diabetes (aOR, 2.60; 95% CI, 1.56–4.39; P < 0.001) were associated with increased risk of 90-day AIS after THA. Conclusions In conclusion, we found that the incidence of 90-day AIS in patients≥70 years old with THA for hip fracture was 2.5%. Older age, diabetes, hyperlipidemia, AF and higher D-dimer value were independent risk factors for 90-day AIS in patients≥70 years old with THA for hip fracture.

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Age-Related Risk Factors and Complications of Patients With COVID-19: A Population-Based Retrospective Study

Frontiers in Medicine ◽

10.3389/fmed.2021.757459 ◽

2022 ◽

Vol 8 ◽

Author(s):

Han Zhang ◽

Yingying Wu ◽

Yuqing He ◽

Xingyuan Liu ◽

Mingqian Liu ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Age Groups ◽

Clinical Manifestations ◽

Population Based ◽

Male Gender ◽

Poor Correlation ◽

Age Related ◽

Related Risk ◽

Independent Risk Factors

Objective: To study the differences in clinical characteristics, risk factors, and complications across age-groups among the inpatients with the coronavirus disease 2019 (COVID-19).Methods: In this population-based retrospective study, we included all the positive hospitalized patients with COVID-19 at Wuhan City from December 29, 2019 to April 15, 2020, during the first pandemic wave. Multivariate logistic regression analyses were used to explore the risk factors for death from COVID-19. Canonical correlation analysis (CCA) was performed to study the associations between comorbidities and complications.Results: There are 36,358 patients in the final cohort, of whom 2,492 (6.85%) died. Greater age (odds ration [OR] = 1.061 [95% CI 1.057–1.065], p < 0.001), male gender (OR = 1.726 [95% CI 1.582–1.885], p < 0.001), alcohol consumption (OR = 1.558 [95% CI 1.355–1.786], p < 0.001), smoking (OR = 1.326 [95% CI 1.055–1.652], p = 0.014), hypertension (OR = 1.175 [95% CI 1.067–1.293], p = 0.001), diabetes (OR = 1.258 [95% CI 1.118–1.413], p < 0.001), cancer (OR = 1.86 [95% CI 1.507–2.279], p < 0.001), chronic kidney disease (CKD) (OR = 1.745 [95% CI 1.427–2.12], p < 0.001), and intracerebral hemorrhage (ICH) (OR = 1.96 [95% CI 1.323–2.846], p = 0.001) were independent risk factors for death from COVID-19. Patients aged 40–80 years make up the majority of the whole patients, and them had similar risk factors with the whole patients. For patients aged <40 years, only cancer (OR = 17.112 [95% CI 6.264–39.73], p < 0.001) and ICH (OR = 31.538 [95% CI 5.213–158.787], p < 0.001) were significantly associated with higher odds of death. For patients aged >80 years, only age (OR = 1.033 [95% CI 1.008–1.059], p = 0.01) and male gender (OR = 1.585 [95% CI 1.301–1.933], p < 0.001) were associated with higher odds of death. The incidence of most complications increases with age, but arrhythmias, gastrointestinal bleeding, and sepsis were more common in younger deceased patients with COVID-19, with only arrhythmia reaching statistical difference (p = 0.039). We found a relatively poor correlation between preexisting risk factors and complications.Conclusions: Coronavirus disease 2019 are disproportionally affected by age for its clinical manifestations, risk factors, complications, and outcomes. Prior complications have little effect on the incidence of extrapulmonary complications.

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Periodontal disease and effects of antipsychotic medications in patients newly diagnosed with schizophrenia: a population-based retrospective cohort

Epidemiology and Psychiatric Sciences ◽

10.1017/s204579601900043x ◽

2019 ◽

Vol 29 ◽

Author(s):

Kai-Fang Hu ◽

Pei-Shan Ho ◽

Yu-Hsiang Chou ◽

Jui-Hsiu Tsai ◽

Chung-Hung Richard Lin ◽

...

Keyword(s):

Risk Factors ◽

Periodontal Disease ◽

First Generation ◽

Protective Factor ◽

Population Based ◽

Newly Diagnosed ◽

Sugary Drinks ◽

Increased Risk ◽

History Of ◽

Independent Risk Factors

Abstract Aim Compared with the general population, individuals with schizophrenia have a higher risk of periodontal disease, which can potentially reduce their life expectancy. However, evidence for the early development of periodontal disease in schizophrenia is scant. The current study investigated risk factors for periodontal disease in patients newly diagnosed with schizophrenia. Methods We identified a population-based cohort of patients in Taiwan with newly diagnosed schizophrenia who developed periodontal disease within 1 year of their schizophrenia diagnosis. Treatment with antipsychotics and other medications was categorised according to medication type and duration, and the association between medication use and the treated periodontal disease was assessed through logistic regression. Results Among 3610 patients with newly diagnosed schizophrenia, 2373 (65.7%) had an incidence of treated periodontal disease during the 1-year follow-up. Female sex (adjusted odds ratios [OR] 1.40; 95% confidence interval [CI] 1.20–1.63); young age (adjusted OR 0.99; 95% CI 0.98–0.99); a 2-year history of periodontal disease (adjusted OR 2.45; 95% CI 1.84–3.26); high income level (adjusted OR 2.24; 95% CI 1.64–3.06) and exposure to first-generation (adjusted OR 1.89; 95% CI 1.54–2.32) and secondary-generation (adjusted OR 1.33; 95% CI 1.11–1.58) antipsychotics, anticholinergics (adjusted OR 1.24; 95% CI 1.03–1.50) and antihypertensives (adjusted OR 1.91; 95% CI 1.64–2.23) were independent risk factors for periodontal disease. Hyposalivation – an adverse effect of first-generation antipsychotics (FGAs) (adjusted OR 2.00; 95% CI 1.63–2.45), anticholinergics (adjusted OR 1.27; 95% CI 1.05–1.53) and antihypertensives (adjusted OR 1.90; 95% CI 1.63–2.22) – was associated with increased risk of periodontal disease. Therefore, hypersalivation due to FGA use (adjusted OR 0.72; 95% CI 0.59–0.88) was considered a protective factor. Conclusions The current study highlights that early prevention of periodontal disease in individuals with schizophrenia is crucial. Along with paying more attention to the development of periodontal disease, assessing oral health regularly, helping with oral hygiene, and lowering consumption of sugary drinks and tobacco, emphasis should also be given by physicians to reduce the prescription of antipsychotics to the extent possible under efficacious pharmacotherapy for schizophrenia.

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Incidence, type of atrial fibrillation and risk factors for stroke: a population-based cohort study

Clinical Epidemiology ◽

10.2147/clep.s122916 ◽

2017 ◽

Vol Volume 9 ◽

pp. 53-62 ◽

Cited By ~ 5

Author(s):

Cecilia Johansson ◽

Erik Dahlqvist ◽

Jonas Andersson ◽

Jan-Håkan Jansson ◽

Lars Johansson

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Cohort Study ◽

Population Based

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Atrial Fibrillation Manifestations Risk Factors and Sex Differences in a Population-Based Cohort (From the Gutenberg Health Study)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2018.03.028 ◽

2018 ◽

Vol 122 (1) ◽

pp. 76-82 ◽

Cited By ~ 4

Author(s):

Christina Magnussen ◽

Francisco M. Ojeda ◽

Philipp S. Wild ◽

Nils Sörensen ◽

Thomas Rostock ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Sex Differences ◽

Population Based ◽

Health Study ◽

Gutenberg Health Study

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Effect of Insulin Resistance on Recurrence After Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation

10.21203/rs.3.rs-1035416/v1 ◽

2021 ◽

Author(s):

Zhe Wang ◽

Yi-Jia Wang ◽

Zhi-Yu Liu ◽

Qing Li ◽

Ya-wei Kong ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Insulin Resistance ◽

Fasting Blood Glucose ◽

Multivariable Analysis ◽

Diabetic Patients ◽

Model Assessment ◽

Af Ablation ◽

Independent Risk Factors ◽

Af Recurrence

Abstract Background Recurrence after atrial fibrillation(AF) ablation has many risk factors. the relationship between the recurrence rate after ablation and IR in the non-diabetic patients with AF is not clear.MethodsRetrospective cohort study enrolled AF patients without diabetes who underwent ablation between 2018~2019 in the first affiliated hospital of zhengzhou university. Homeostasis model assessment of insulin resistance (HOMA‐IR) was calculated and a value of ≥2.69 was defined as insulin resistant(IR). The patients were categaried into two groups: those with HOMA‐IR<2.69 in group 1(n=163); HOMA‐IR≥2.69 in group 2 (n=69). Multivariable adjusted Cox proportional hazard models were performed to compare the risk of AF recurrence after ablation. The definition of AF recurrence was documented AF, atrial flutter, or atrial tachycardia lasting >30 seconds recorded in ECG or 24‐hour Holter monitoring after 3 months blanking period.Results232 AF patients receiving ablation were enrolled and the median age was 59.5±11.3 years . There were 166 cases of paroxysmal AF and 66 cases of persistent AF. Patients with IR (n=69)were more likely to have Dyslipidemia, higher fasting blood glucose and fasting insulin than those in non-IR group. Patients with IR also were more likely to recieve antiarrhythmic drugs before ablation. After a mean follow‐up of 322±85 days, 62(26.7%) patients had documented recurrence of AF. Multivariable analysis showed that HOMA-IR value and left atrial diameter（LAD）were independent risk factors for recurrence after AF ablation (HR: 1.259, 95% CI:1.086~1.460, P=0.002; HR: 1.043, 95% CI:1.005~1.083, P=0.025; respectively).ConclusionsHOMA-IR and LAD are independent risk factors for AF recurrence after ablation in patients without diabetes.

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