scholarly journals Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yun Gi Kim ◽  
Yun Young Choi ◽  
Kyung-Do Han ◽  
Kyongjin Min ◽  
Ha Young Choi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Arrhythmias ◽  
Population Based ◽  
Cardiac Events ◽  
Population Based Study ◽  
Increased Risk ◽  
Adverse Cardiac Events ◽  
Korean National Health Insurance ◽  
New Onset

AbstractAtrial fibrillation (AF) is associated with various major adverse cardiac events such as ischemic stroke, heart failure, and increased overall mortality. However, its association with lethal ventricular arrhythmias such as ventricular tachycardia (VT), ventricular flutter (VFL), and ventricular fibrillation (VF) is controversial. We conducted this study to determine whether AF can increase the risk of VT, VFL, and VF. We utilized the Korean National Health Insurance Service database for this nationwide population-based study. This study enrolled people who underwent a nationwide health screen in 2009 for whom clinical follow-up data were available until December 2018. Primary outcome endpoint was the occurrence of VT, VFL, or VF in people who were and were not diagnosed with new-onset AF in 2009. We analyzed a total of 9,751,705 people. In 2009, 12,689 people were diagnosed with new-onset AF (AF group). The incidence (events per 1000 person-years of follow-up) of VT, VFL, and VF was 2.472 and 0.282 in the AF and non-AF groups, respectively. After adjustment for covariates, new-onset AF was associated with 4.6-fold increased risk (p < 0.001) of VT, VFL, and VF over 10 years of follow-up. The risk of VT, VFL, and VF was even higher if identification of AF was based on intensified criteria (≥ 2 outpatient records or ≥ 1 inpatient record; hazard ratio = 5.221; p < 0.001). In conclusion, the incidence of VT, VFL, and VF was significantly increased in people with new-onset AF. The potential risk of suffering lethal ventricular arrhythmia in people with AF should be considered in clinical practice.

scholarly journals Fluctuating renal function and the risk of incident atrial fibrillation: a nationwide population-based study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Soonil Kwon ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Seokhun Yang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Renal Function ◽  
Population Based ◽  
Incidence Rates ◽  
Population Based Study ◽  
Increased Risk ◽  
Study Population ◽  
Multiple Variables ◽  
The Impact

AbstractAlthough chronic kidney disease is known to increase the risk of atrial fibrillation (AF), the impact of the variability of renal function on the risk of incident AF is unknown. We aimed to evaluate the association between variability of renal function and the risk of developing AF among the general population. We evaluated a total of 3,551,249 adults who had three annual health check-ups provided by the National Health Insurance Service. The variability of renal function was defined as GFR-VIM, which is variability independent of the mean (VIM) of creatinine-based estimated glomerular filtration rate (eGFR). The study population was divided into four groups (Q1-4) based on the quartiles of GFR-VIM, and the risks of incident AF by each group were compared. During a mean of 3.2 ± 0.5 years follow-up, incident AF occurred in 15,008 (0.42%) subjects. The incidence rates of AF increased from Q1 to Q4 (0.98, 1.42, 1.27, and 1.63 per 1,000 person-years, respectively). Adjusting with multiple variables, Q4 showed an increased risk of incident AF compared to Q1 (hazard ratio (HR) 1.125, 95% confidence interval (CI) 1.071–1.181). Variability of serum creatinine or other definitions of variability showed consistent results. On subgroup analyses, Q4 in males or those with a decreasing trend of eGFR had significantly increased risks of incident AF compared to Q1 (HR 1.127, 95% CI 1.082–1.175; and HR 1.115, 95% CI 1.059–1.173, respectively). High variability of eGFR was associated with an increased risk of incident AF, particularly in males or those with decreasing trends of eGFR during follow-up.

scholarly journals Subclinical Measures of Peripheral Atherosclerosis and the Risk of New‐Onset Atrial Fibrillation in the General Population: the Rotterdam Study

2021 ◽  
Author(s):  
Sven Geurts ◽  
Cathrine Brunborg ◽  
Grigorios Papageorgiou ◽  
M. Arfan Ikram ◽  
Maryam Kavousi
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Carotid Plaque ◽  
Population Based ◽  
Rotterdam Study ◽  
Link Type ◽  
Increased Risk ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background Limited population‐based data on the (sex‐specific) link between subclinical measures of peripheral atherosclerosis and new‐onset atrial fibrillation (AF) exist. Methods and Results Subclinical measures of peripheral atherosclerosis including carotid intima‐media thickness (cIMT), carotid plaque, and ankle‐brachial index (ABI) were assessed at baseline and follow‐up examinations. A total of 12 840 participants free of AF at baseline from the population‐based Rotterdam Study were included. Cox proportional hazards models and joint models, adjusted for cardiovascular risk factors, were used to determine the associations between baseline and longitudinal measures of cIMT, carotid plaque, and ABI with new‐onset AF. During a median follow‐up of 9.2 years, 1360 incident AF cases occurred among 12 840 participants (mean age 65.2 years, 58.3% women). Higher baseline cIMT (fully‐adjusted hazard ratio [HR], 95% CI, 1.81, 1.21–2.71; P =0.0042), presence of carotid plaque (fully‐adjusted HR, 95% CI, 1.19, 1.04–1.35; P =0.0089), lower ABI (fully‐adjusted HR, 95% CI, 1.57, 1.14–2.18; P =0.0061) and longitudinal measures of higher cIMT (fully‐adjusted HR, 95% CI, 2.14, 1.38–3.29; P =0.0021), presence of carotid plaque (fully‐adjusted HR, 95% CI, 1.61, 1.12–2.43; P =0.0112), and lower ABI (fully‐adjusted HR, 95% CI, 4.43, 1.83–10.49; P =0.0007) showed significant associations with new‐onset AF in the general population. Sex‐stratified analyses showed that the associations for cIMT, carotid plaque, and ABI were mostly prominent among women. Conclusions Baseline and longitudinal subclinical measures of peripheral atherosclerosis (carotid atherosclerosis, and lower extremity peripheral atherosclerosis) were significantly associated with an increased risk of new‐onset AF, especially among women. Registration URL: https://www.trialregister.nl , https://www.apps.who.int/trialsearch/ ; Unique identifier: NL6645/NTR6831.

2225“New-onset atrial fibrillation efter cardiac surgery is associated with increased long-term morbidity and mortality”: a population-based study from the SWEDEHEART-registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Taha ◽  
A Jeppsson ◽  
L Friberg ◽  
S Nielsen ◽  
A Ahlsson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Population Based ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Cabg Patients ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Background New-onset postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, but the prognostic implications are not settled. In contrast to previous reports, a recent Danish study in coronary bypass surgery (CABG) patients (Butt et al. JAMA Cardiol 2018) did not show any increased risk for thromboembolic complications in POAF patients. Purpose To compare long-term outcome in patients with vs. without POAF after CABG. Methods All CABG patients in Sweden 2005–2015 (n=38040) were included in a retrospective population-based cohort study. Data from the SWEDEHEART registry, the National Patient Registry and the National Population Registry were merged. POAF was defined as any new-onset atrial fibrillation (AF) episode up to the 30thpostoperative day. Inverse Probability Treatment Weighting (IPTW) adjusted Cox regression models were used to compare outcome variables after the first 30 postoperative days until the end of follow-up (median 5 years, range 0–10). The models were adjusted for age, gender, CHA2DS2-VASc score, co-morbidity, and medications. Results The mean age of the entire cohort was 68 years, 79% were men and 90% had a CHA2DS2-VASc score ≥2. The incidence of POAF was 28.5% (10845/38040). During follow-up POAF, patients had a significantly higher adjusted risk for all-cause mortality [Hazard Ratio (HR) 1.16 (95% CI 1.09–1.24)], ischemic stroke [HR 1.19 (1.09–1.30)], transient ischemic attack [HR 1.17 (1.03–1.33)], pulmonary embolism [HR 1.24 (1.01–1.54)], myocardial infarction [HR 1.14 (1.04–1.25)], heart failure hospitalizations [HR.1.46 (1.35–1.59)] and recurrent AF [HR 4.33 (4.09–4.65)]. Conclusions POAF was in this comparatively large study associated with increased risk for mortality and morbidity during long-term follow-up after CABG and is hence not a trivial complication.

P664Impact of dynamic change in the status of metabolic syndrome associated with the risk of atrial fibrillation: a nationwide population-based study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Lee ◽  
E K Choi ◽  
S R Lee ◽  
K Han ◽  
M J Cha ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Metabolic Syndrome ◽  
Dynamic Change ◽  
Density Lipoprotein ◽  
Population Based ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
The Status ◽  
New Onset

Abstract Background/Introduction Metabolic syndrome (MetS) is a well-known risk factor for new-onset atrial fibrillation (AF). However, there is a paucity of information on whether the change of MetS status has an impact on the risk of new-onset AF. Objective We aimed to evaluate the risk of AF according to the change of MetS status and to find whether components of metabolic syndrome control may affect AF risk. Methods A total of 7,565,531 subjects (≥20-year-old, mean age 47.2±13.7 years, male 55.6%) without prevalent AF who underwent 2 times of serial health checkup were identified from the Korean National Health Insurance Service. MetS was defined as having ≥3 of the following risk factors: increased waist circumference (ethnicity-specific, in Asian, ≥80 cm in women or ≥90 cm in men), increased triglycerides (≥150 mg/dL), decreased high-density lipoprotein-cholesterol level (<40 mg/dL in males, <50 mg/dL in females), increased blood pressure (≥130/85 mmHg), and increased fasting glucose level (≥100 mg/dL). Subjects stratified into four groups according to the change of MetS status during the follow-up period: 1,388,850 patients persistent MetS in the serial checkup (MM group), 608,158 in previous healthy but newly diagnosed MetS at 2nd checkup (HM group), 798,555 in the previous MetS but became healthy in 2nd checkup (MH group), and 4,769,968 patients without MetS in both (HH group). Incident AF was followed up till December 2017. Results Among those with MetS, 798,555 patients had improved to be healthy (10.6%). In those previous without MetS, 608,158 patients had newly diagnosed as MetS (8.0%) in 2nd checkup. During a mean follow-up of 7.9±0.9 years, incident AF was diagnosed in 135,600 patients (2.3 per 1000 person-year). MM, MH, and HM groups showed an increased risk of AF compared to HH group (Figure). Also, MH group showed a lower risk of AF compared to those with MM group. Regardless of the type of component that meets the MetS criteria, the risk of AF became different according to changing the number of MetS components. The risk of AF increased as the number of MetS components increased, whereas the risk of AF decreased as the number of MetS components decreased. Risk of AF according to change of MetS Conclusion The risk of AF showed association with the dynamic change of MetS status and the variation in the number of MetS components. AF risk was reduced by the improvement in metabolic syndrome and each of MetS components.

scholarly journals Depression and risk of atrial fibrillation: a nationwide population-based study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Choi ◽  
K.N Lee ◽  
Y.G Kim ◽  
J.H Jeong ◽  
H.Y Choi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
National Health ◽  
Population Based ◽  
Biological Mechanisms ◽  
Health Checkup ◽  
Population Based Study ◽  
Depression Group ◽  
Treatment Of Depression ◽  
Increased Risk ◽  
New Onset

Abstract Background Although treatments of atrial fibrillation (AF) based on the biological mechanisms for initiation and maintenance of AF improve cardiovascular outcomes, psychosocial factors have been also implicated in the etiology and progression of cardiovascular disease. Objective We aimed to evaluate the association between depression and incident AF using nationwide database from the National Health Insurance Service in South Korea. Methods A total of 9,075,224 participants with data of national health checkup in 2009 were included, and participants who were diagnosed with AF before the examination were excluded. Exposure to depression is determined by the precedence of depression diagnosed within 2 years. Results Depression was diagnosed in 1.37% (124,709) of participants at baseline. Compared to the non-depression group, depression group was likely to be female and had higher comorbidities. After adjusting covariates, depression group had a higher risk of incident AF compared with non-depression group (hazard ratio, 1.30; 95% confidence interval, 1.26–1.34). Repeated exposure to depression increased a risk of incident AF (Figure 1). Conclusion Depression was associated with an increased risk of new-onset AF. This association was stronger for patients who had more burden of depression. Future studies should investigate whether early treatment of depression can prevent incident AF. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Acute Dental Periapical Abscess and New-Onset Atrial Fibrillation: A Nationwide, Population-Based Cohort Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2927
Author(s):  
Amaar Obaid Hassan ◽  
Gregory Y. H. Lip ◽  
Arnaud Bisson ◽  
Julien Herbert ◽  
Alexandre Bodin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Multivariable Analysis ◽  
National Database ◽  
Increased Risk ◽  
Periapical Abscess ◽  
The Relationship ◽  
Onset Atrial Fibrillation ◽  
New Onset

There are limited data on the relationship of acute dental infections with hospitalisation and new-onset atrial fibrillation (AF). This study aimed to assess the relationship between acute periapical abscess and incident AF. This was a retrospective cohort study from a French national database of patients hospitalized in 2013 (3.4 million patients) with at least five years of follow up. In total, 3,056,291 adults (55.1% female) required hospital admission in French hospitals in 2013 while not having a history of AF. Of 4693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess that developed AF over a mean follow-up of 4.8 ± 1.7 years. Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01). The CHA2DS2VASc score in patients with acute dental periapical abscess had moderate predictive value for development of AF, with Area Under the Curve (AUC) 0.73 (95% CI, 0.71–0.76). An increased risk of new onset AF was identified for individuals hospitalized with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections is needed for incident AF, as well as investigations of possible mechanisms linking these conditions.

scholarly journals Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Hossein Farhadnejad ◽  
Karim Parastouei ◽  
Hosein Rostami ◽  
Parvin Mirmiran ◽  
Fereidoun Azizi
Keyword(s):  
Metabolic Syndrome ◽  
Positive Association ◽  
Population Based ◽  
Population Based Study ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Confounding Variables ◽  
Adjusted Model ◽  
Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

scholarly journals Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3126
Author(s):  
Jaehyun Lim ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Jin-Hyung Jung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Reduction ◽  
Lower Risk ◽  
Population Based ◽  
Newly Diagnosed ◽  
Incident Dementia ◽  
Before And After ◽  
Korean National Health Insurance ◽  
New Diagnosis ◽  
New Onset

Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using the Korean National Health Insurance Service database, we enrolled a total of 126,555 patients with newly diagnosed AF between 2010 and 2016, who underwent health examinations within two years before and after their diagnosis of AF. The patients were divided into four groups: persistent non-exercisers, exercise starters, exercise quitters, and exercise maintainers. Results: Based on a total of 396,503 person-years of follow-up, 5943 patients were diagnosed with dementia. Compared to persistent non-exercisers, exercise starters (adjusted hazard ratio (aHR) 0.87; 95% confidence interval (CI) 0.81–0.94), and exercise maintainers (aHR 0.66; 95% CI 0.61–0.72) showed a lower risk of incident dementia; however, the risk was similar in exercise quitters (aHR 0.98; 95% CI 0.92–1.05) (p-trend < 0.001). There was a J-shaped relationship between the dose of exercise and the risk of dementia, with the risk reduction maximized at 5–6 times per week of moderate-to-vigorous PA among exercise starters. Conclusion: Patients who initiated or continued regular exercise after diagnosis of AF were associated with a lower risk of dementia than persistent non-exercisers, with no risk reduction associated with exercise cessation. Our findings may provide evidence for the benefit of exercise prescription to patients with new-onset AF to prevent incident dementia regardless of their current exercise status.

scholarly journals Obesity, Abdominal Obesity and Chronic Kidney Disease in Young Adults: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 1065
Author(s):  
Eun Hui Bae ◽  
Sang Yeob Lim ◽  
Jin-Hyung Jung ◽  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Young Adults ◽  
Kidney Disease ◽  
Abdominal Obesity ◽  
Population Based ◽  
Baseline Body Mass Index ◽  
Increased Risk ◽  
Baseline Examination ◽  
New Onset

Obesity has become a pandemic. It is one of the strongest risk-factors of new-onset chronic kidney disease (CKD). However, the effects of obesity and abdominal obesity on the risk of developing CKD in young adults has not been elucidated. From a nationwide health screening database, we included 3,030,884 young adults aged 20–39 years without CKD during a baseline examination in 2009–2010, who could follow up during 2013–2016. Patients were stratified into five levels based on their baseline body mass index (BMI) and six levels based on their waist circumference (WC; 5-cm increments). The primary outcome was the development of CKD. During the follow up, until 2016, 5853 (0.19%) participants developed CKD. Both BMI and WC showed a U-shaped relationship with CKD risk, identifying the cut-off values as a BMI of 21 and WC of 72 cm in young adults. The obesity group (odd ratio [OR] = 1.320, 95% confidence interval [CI]: 1.247–1.397) and abdominal obesity group (male WC ≥ 90, female WC ≥ 85) (OR = 1.208, 95%CI: 1.332–1.290) showed a higher CKD risk than the non-obesity or non-abdominal obesity groups after adjusting for covariates. In the CKD risk by obesity composite, the obesity displayed by the abdominal obesity group showed the highest CKD risk (OR = 1.502, 95%CI: 1.190–1.895), especially in those under 30 years old. During subgroup analysis, the diabetes mellitus (DM) group with obesity or abdominal obesity paradoxically showed a lower CKD risk compared with the non-obesity or non-abdominal obesity group. Obesity and abdominal obesity are associated with increased risk of developing CKD in young adults but a decreased risk in young adults with diabetes.

Abstract P208: Functional Status, Rehospitalization, and Mortality Outcomes Among Acute Myocardial Infarction Patients with Prior and New-Onset Atrial Fibrillation

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Kyle P Hornsby ◽  
Kensey Gosch ◽  
Amy L Miller ◽  
Jonathan P Piccini ◽  
Renato D Lopes ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Functional Status ◽  
Physical Function ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
New Onset

Background: Little data are available regarding differences in prognosis and health status between new-onset and prior atrial fibrillation (AF) among patients with acute myocardial infarction (AMI). Methods: The TRIUMPH study enrolled 4340 AMI patients who received longitudinal follow-up including SF-12 health status assessments through 1 year post-AMI. We compared 1-year mortality, rehospitalization, and functional status according to AF type (none, prior, new) after adjusting for differences in baseline characteristics. Results: A total of 212 AMI patients (4.9%) had prior AF and 254 (5.9%) had new-onset AF. Compared with no AF, new AF was associated with older age, male sex, first MI, worse baseline physical function, home atrioventricular nodal blocker use, and worse ventricular function (c-index 0.77). Rates of 1-year mortality were 6.2%, 14.5%, and 13.0%, and 1-year rehospitalization rates were 29.1%, 44.2%, and 36.8% for no, prior, and new AF, respectively. After multivariable adjustment, neither prior nor new AF was associated with increased 1-year mortality, and only prior AF was associated with increased risk of 1-year rehospitalization (Figure). After adjusting for baseline SF-12 physical function scores, patients with prior AF had lower 1-year scores than those with no AF (40.6 vs. 43.7, p <0.003), whereas patients with new AF had similar scores (42.9 vs. 43.7, p=0.36). Conclusion: New-onset AF during AMI is associated with a number of comorbidities but, unlike prior AF, is not associated with adverse outcomes. These results raise the question of whether AF is itself a cause of or simply a marker of comorbidities leading to downstream adverse outcomes after AMI.

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