CHA2DS2VASc score and adverse outcomes in middle-aged individuals without atrial fibrillation

Aims The CHA2DS2VASc score is used to evaluate the risk of thromboembolic events in patients with non-valvular atrial fibrillation. We assessed the prognostic yield of CHA2DS2VASc for new-onset atrial fibrillation, cardiovascular morbidity and mortality in a non-atrial fibrillation population. Methods We analysed a population-based cohort of 22,179 middle-aged individuals with ( n = 3542) and without ( n = 18,367) a history of atrial fibrillation; we grouped the population into five CHA2DS2VASc strata (0–1–2–3–≥4), and compared the risk of major adverse cerebro-cardiovascular events and mortality. Furthermore, we analysed the annual incidence of atrial fibrillation across different CHA2DS2VASc strata. Results Over a median follow-up of 15 years, 1572 patients (6.9%) had ischaemic strokes, 2162 (9.5%) coronary events and 5899 (26%) died. The cumulative incidence of ischaemic stroke in CHA2DS2VASc ≥ 4 subjects without atrial fibrillation was similar to patients with atrial fibrillation and CHA2DS2VASc 2, with a 10-year crude incidence rate of 0.91 (95% confidence interval (CI) 0.68–1.19) and 1.13 (95% CI 0.93–1.36) ischaemic strokes per 100 patient-years, respectively. CHA2DS2VASc in a non-atrial fibrillation population showed higher predictive accuracy for ischaemic stroke compared with an atrial fibrillation population (area under the curve 0.60 vs. 0.56; P = 0.001). In multivariable Cox regression analysis, CHA2DS2VASc ≥ 2 was an independent predictor of all-cause death (adjusted hazard ratio (aHR) 2.58; 95% CI 2.42–2.76), cardiovascular death (aHR 3.40; 95% CI 2.98–3.89), ischaemic stroke (aHR 2.20; 95% CI 1.92–2.53) and coronary events (aHR 1.83; 95% CI 1.63–2.04). The cumulative incidence of atrial fibrillation was greater with increasing CHA2DS2VASc strata, with an absolute annual incidence of more than 2% per year if CHA2DS2VASc ≥ 4. Conclusion The CHA2DS2VASc score is a sensitive tool for predicting new-onset atrial fibrillation and adverse outcomes in subjects both with and without atrial fibrillation.

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Poor Heart Rate Recovery Is Associated With the Development of New-Onset Atrial Fibrillation in Middle-Aged Adults

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2016.08.012 ◽

2016 ◽

Vol 91 (12) ◽

pp. 1769-1777 ◽

Cited By ~ 4

Author(s):

Avi Sabbag ◽

Anat Berkovitch ◽

Yechezkel Sidi ◽

Shaye Kivity ◽

Sagit Ben Zekry ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Rate ◽

Heart Rate Recovery ◽

Middle Aged ◽

Middle Aged Adults ◽

Onset Atrial Fibrillation ◽

New Onset

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New onset atrial fibrillation due to isolated cor triatriatum in a middle-aged woman

Acta Cardiologica ◽

10.1080/ac.70.2.3073519 ◽

2015 ◽

Vol 70 (2) ◽

pp. 247-247

Author(s):

Priyank Shah ◽

Vipin Mittal ◽

Fadi Alattar ◽

Donna Konlian ◽

Aderemi Soyombo ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cor Triatriatum ◽

Middle Aged ◽

Aged Woman ◽

Middle Aged Woman ◽

Onset Atrial Fibrillation ◽

New Onset

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The Performance of the HATCH Score for Predicting New-Onset Atrial Fibrillation in An Elderly Hospital-Based Chinese Population

10.21203/rs.3.rs-994486/v1 ◽

2021 ◽

Author(s):

Haiyun Wu ◽

Ruozhu Dai ◽

Min Wang ◽

Chengbo Chen

Keyword(s):

Atrial Fibrillation ◽

Chinese Population ◽

Cox Regression ◽

Predictive Ability ◽

Scoring Systems ◽

The Elderly ◽

Individual Risk ◽

Cox Regression Analysis ◽

Onset Atrial Fibrillation ◽

New Onset

Abstract BACKGROUND: The aging population represents high risk in developing new-onset atrial fibrillation (NOAF). Assessing individual risk of NOAF is pivotal for primary prevention. The role of the HATCH score for predicting NOAF in the elderly hospital-based Chinese population has never been evaluated.METHODS: In our center, the development of NOAF was followed among patients aged over 65 years. Incidence of NOAF was calculated. Risk factors for NOAF were investigated using uni- and multivariable Cox regression analysis. The performance of the HATCH score for predicting NOAF was evaluated using Kaplan-Meier curve analysis with DeLong test and C-indexes.RESULTS: A total of 7718 elderly patients were enrolled in the present study, with 421 developed NOAF during 3.18 ± 3.73 years of follow-up with an incidence of 1.71 (95%CI 1.55-1.89) per 100 patient-years. After adjusted with cofounders, only hypertension (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.23-1.85), COPD (HR 1.86, 95%CI 1.22-2.84) and HF (HR 1.82, 95%CI 1.28-2.59) were independently related to NOAF. The risk of NOAF increased with a higher HATCH score (38% higher risk per 1-point increase). Among those with a HATCH score ≥4, the risk of NOAF was 4.01 (95%CI 3.85-4.16) per 100 patient-years (Log-rank P <0.001). The C-index for the HATCH score was moderate (0.60 [95%CI, 0.57-0.63]), which was better than the single criteria but comparative to other scoring systems.CONCLUSION: In this elderly hospital-based Chinese population, the HATCH score had a moderate predictive ability for NOAF.

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Troponin Levels Help Predict New-Onset Atrial Fibrillation in Ischaemic Stroke Patients: A Retrospective Study

European Neurology ◽

10.1159/000258679 ◽

2010 ◽

Vol 63 (1) ◽

pp. 24-28 ◽

Cited By ~ 20

Author(s):

Jean-Marc Bugnicourt ◽

Vincent Rogez ◽

Marie-Pierre Guillaumont ◽

Jean-Claude Rogez ◽

Sandrine Canaple ◽

...

Keyword(s):

Atrial Fibrillation ◽

Retrospective Study ◽

Ischaemic Stroke ◽

Stroke Patients ◽

Onset Atrial Fibrillation ◽

New Onset

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Body mass index and the risk of new-onset atrial fibrillation in middle-aged adults

American Heart Journal ◽

10.1016/j.ahj.2015.11.016 ◽

2016 ◽

Vol 173 ◽

pp. 41-48 ◽

Cited By ~ 24

Author(s):

Anat Berkovitch ◽

Shaye Kivity ◽

Robert Klempfner ◽

Shlomo Segev ◽

Assi Milwidsky ◽

...

Keyword(s):

Atrial Fibrillation ◽

Body Mass Index ◽

Body Mass ◽

Middle Aged ◽

Middle Aged Adults ◽

Onset Atrial Fibrillation ◽

New Onset

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MO397THE IMPACT OF NEW-ONSET ATRIAL FIBRILLATION ON ADVERSE OUTCOMES IN PATIENTS WITH SEPSIS-INDUCED ACUTE KIDNEY INJURY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab082.0051 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Zorica Dimitrijevic ◽

Branka Mitic ◽

Sonja Salinger ◽

Goran Paunovic ◽

Stevan Glogovac ◽

...

Keyword(s):

Atrial Fibrillation ◽

Acute Kidney Injury ◽

Univariate Analysis ◽

Kidney Injury ◽

Adverse Outcomes ◽

Intermittent Hemodialysis ◽

Replacement Treatment ◽

Number Of Patients ◽

Onset Atrial Fibrillation ◽

New Onset

Abstract Background and Aims The mortality of septic patients with acute kidney injury (s-AKI) prevails high. Atrial fibrillation is commonly observed in the setting of systemic inflammation or infection. The study aimed to assess the incidence and predictors of new-onset atrial fibrillation (NOAF) in this population and its impact on intrahospital mortality. Method We conducted a retrospective cohort study of 462 patients admitted to our unit for s-AKI between January 2016 and December 2020. NOAF was defined as AF discovered during hospitalization in patients with sinus rhythm on admission. Subjects were classified into NOAF (n=68) and non-NOAF groups (n=364). There were no major differences in sepsis severity between groups, and all patients underwent intermittent hemodialysis as a renal replacement treatment modality. Results The NOAF incidence in the whole s-AKI population was 14.7%. In a univariate analysis, age (72.4 in patients with NOAF vs. 62.1 years in patients without NOAF, respectively; p=0.018), male gender (33.5 vs. 14.6%; p= 0.004), history of coronary disease (23.5 vs. 6.1%; p=0.07) and vasopressor medication use (19.0 vs. 8.2%; p = 0.002) were associated with NOAF. 116 (25.1%) patients died during the hospitalization, while 346 patients (74.9%) were discharged from the hospital. NOAF occurring in s-AKI was independently associated with an increased hazard of intrahospital death (HR: 1.36; 95% CI: 1.09–1.51), compared to the non-NOAF group. Conclusion A clinically significant number of patients hospitalized for s-AKI have NOAF, and it is associated with poor hospital outcomes.

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Metabolic Syndrome and the Risk of New-Onset Atrial Fibrillation in Middle-Aged East Asian Men

Circulation Journal ◽

10.1253/circj.cj-18-0113 ◽

2018 ◽

Vol 82 (7) ◽

pp. 1763-1769 ◽

Cited By ~ 3

Author(s):

Yong-Giun Kim ◽

Kee-Joon Choi ◽

Seungbong Han ◽

Ki Won Hwang ◽

Chang Hee Kwon ◽

...

Keyword(s):

Atrial Fibrillation ◽

Metabolic Syndrome ◽

East Asian ◽

Middle Aged ◽

Asian Men ◽

Onset Atrial Fibrillation ◽

New Onset

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Previous and New Onset Atrial Fibrillation and Associated Outcomes in Acute Coronary Syndromes (from the Global Registry of Acute Coronary Events)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2018.06.001 ◽

2018 ◽

Vol 122 (6) ◽

pp. 944-951 ◽

Cited By ~ 1

Author(s):

Mali D. Worme ◽

Mary K. Tan ◽

David W.J. Armstrong ◽

Andrew T. Yan ◽

Nigel S. Tan ◽

...

Keyword(s):

Atrial Fibrillation ◽

Acute Coronary Syndromes ◽

Coronary Syndromes ◽

Coronary Events ◽

Global Registry ◽

Onset Atrial Fibrillation ◽

New Onset

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New-onset atrial fibrillation: incidence, characteristics, and related events following a national COVID-19 lockdown of 5.6 million people

European Heart Journal ◽

10.1093/eurheartj/ehaa494 ◽

2020 ◽

Vol 41 (32) ◽

pp. 3072-3079 ◽

Cited By ~ 14

Author(s):

Anders Holt ◽

Gunnar H Gislason ◽

Morten Schou ◽

Bochra Zareini ◽

Tor Biering-Sørensen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischaemic Stroke ◽

Odds Ratio ◽

Patient Characteristics ◽

Related Event ◽

History Of ◽

Rate Ratios ◽

Onset Atrial Fibrillation ◽

History Of Cancer ◽

New Onset

Abstract Aim To determine the incidence, patient characteristics, and related events associated with new-onset atrial fibrillation (AF) during a national COVID-19 lockdown. Methods and results Using nationwide Danish registries, we included all patients, aged 18–90 years, receiving a new-onset AF diagnosis during the first 3 months of 2019 and 2020. The main comparison was between patients diagnosed during lockdown (12 March 12–1 April 2020) and patients diagnosed in the corresponding period 1 year previously. We found a lower incidence of new-onset AF during the 3 weeks of lockdown compared with the corresponding weeks in 2019 [incidence rate ratios with 95% confidence intervals (CIs) for the 3 weeks: 0.66 (0.56–0.78), 0.53 (0.45–0.64), and 0.41 (0.34–0.50)]. There was a 47% drop in total numbers (562 vs. 1053). Patients diagnosed during lockdown were younger and with a lower CHA2DS2-VASc score, while history of cancer, heart failure, and vascular disease were more prevalent. During lockdown, 30 (5.3%) patients with new-onset AF suffered an ischaemic stroke and 15 (2.7%) died, compared with 45 (4.3%) and 14 (1.3%) patients during the corresponding 2019 period, respectively. The adjusted odds ratio of a related event (ischaemic stroke or all-cause death) during lock-down compared with the corresponding weeks was 1.41 (95% CI 0.93–2.12). Conclusions Following a national lockdown in Denmark, a 47% drop in registered new-onset AF cases was observed. In the event of prolonged or subsequent lockdowns, the risk of undiagnosed AF patients developing complications could potentially translate into poorer outcomes in patients with AF during the COVID-19 pandemic.

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