Abstract
ObjectivesThis study aims to investigate the impact of newly diagnosed atrial fibrillation (AF) on future major adverse cardiac events (MACE). AF is the most common form of cardiac arrhythmia and is associated with several other cardiovascular (CV) events. Little is known about whether newly diagnosed AF is an independent factor for future MACE, especially in patients without such a history.Methods and ResultsWe evaluated data from the National Health Insurance Research Database, which represented a retrospective cohort of 713,288 adults in Taiwan from 2006 to 2010. Individuals with previous MACE were excluded. Newly diagnosed AF patients were identified by assigning International Classification of Diseases codes. Propensity score matching adjusted for gender, age, hypertension, diabetes mellitus and dyslipidemia. Cox proportional hazard models estimated future MACE ratios. We compared a total of 3,737 patients with newly diagnosed AF and 704,225 patients without. After matching, there was no difference in baseline demographic characteristics in patients across newly diagnosed AF and non-AF groups. The result showed that newly diagnosed AF in multivariate analysis were associated with increased incidents of MACE (hazard ratio: 3.11-3.51 in different models) and mortality. Newly diagnosed AF without other CV risk factors had 8.45 times the risk of developing future MACE than healthy adults. The more associated CV risk factors in addition to AF, the increased rate of future CV events.ConclusionsNewly diagnosed AF is an independent factor that leads to future CV events after gender, age, hypertension, diabetes mellitus and dyslipidemia matching. AF is associated with a higher mortality rate.
Highlights
Atrial fibrillation (AF) is the most common cardiac arrhythmia and affects more than 1.2% of the general population [1]
We evaluated data from the National Health Insurance Research Database, which represented a retrospective cohort of 713,288 adults in Taiwan from 2006 to 2010
Diagnosed AF is an independent factor that leads to future CV events after gender, age, hypertension, diabetes mellitus and dyslipidemia matching
Summary
Atrial fibrillation (AF) is the most common cardiac arrhythmia and affects more than 1.2% of the general population [1]. AF in patients with cardiac comorbidities, such as HF with or without left ventricular dysfunction [10, 13] and myocardial infarction [8], are associated with an increased risk of cardiovascular (CV) events and mortality. Little is known about the influence of newly diagnosed AF on major adverse cardiovascular events (MACE), such as myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), HF, stroke, malignant dysrhythmia, thrombolysis and cardiogenic shock, especially in patients without pre-existing events. We analyzed a large-scale, population-based data in an Asian population from National Health Insurance (NHI) claims records in Taiwan to evaluate the impact of newly diagnosed AF on future CV events in adults without pre-existing MACE
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