Data regarding the relation of the type of atrial fibrillation (AF) to the incidence
of cardiac events remain scarce. This study sought to investigate the association
of AF type with the incidences of cardiac death and heart failure (HF) hospitalization
between paroxysmal and sustained (persistent/permanent) AF in the overall population
and in age subgroups (≤74, 75 to 84, and ≥85 years), using the data from a Japanese
community-based prospective survey, the Fushimi AF Registry. The participants started
to be enrolled since March 2011, and follow-up data were available for 4,304 patients
by the end of November 2017. Patients with sustained AF (n = 2,187, 50.8%) had more
co-morbidities with higher mean CHA2DS2-VASc score than those with paroxysmal AF (n = 2,117, 49.2%) (sustained vs paroxysmal:
3.57 ± 1.69 vs 3.17 ± 1.67, p <0.001). During a median follow-up of 1,307 (interquartile
range: 709 to 2,156) days, the composite of cardiac death and HF hospitalization occurred
more frequently in those with sustained AF (event rate: 5.1 vs 2.8 per 100 person-years;
p <0.001). On multivariate analysis, sustained AF was independently associated with
higher incidence of this composite end point (adjusted hazard ratio [HR]: 1.35, 95%
confidence interval [CI]: 1.12 to 1.63, p = 0.002). In age subgroups, this association
was observed only in the younger AF patients (≤74 years) (adjusted HR: 2.03, 95% CI:
1.44 to 2.86, p <0.001), but not in the older subgroups (p = 0.018 for interaction).
In conclusion, sustained AF was associated with higher incidence of the composite
of cardiac death and HF hospitalization than paroxysmal AF, with different relations
seen depending on age subgroups.
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Article info
Publication history
Published online: August 07, 2019
Received in revised form:
July 23,
2019
Received:
May 9,
2019
Footnotes
Funding: This research is partially supported by the Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus from Japan Agency for Medical Research and Development, AMED (18ek0210082h0002, 18ek0210056h0003).
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© 2019 Elsevier Inc. All rights reserved.
