This article is more than 5 years old. Information may no longer be current.
CV risk factors occur more often before diagnosis of AF
Click Here to Manage Email Alerts
The prevalence of stroke, MI and HF increases closer to diagnosis of atrial fibrillation, according to new data.
All CV risk factors have a distinct trajectory in prevalence among patients with AF, and all play different roles in the pathogenesis of AF, the researchers wrote.
Faye L. Norby, MS, MPH, of the division of epidemiology and community health at the University of Minnesota School of Public Health, and colleagues used data from the ARIC study to pursue two aims: No. 1, to describe the long-term prevalence of risk factors preceding AF diagnosis and the subsequent development of CV outcomes after diagnosis and compare the risk factors and outcomes by AF status; and No. 2, to identify subgroups of individuals with similar trajectories of risk factors and outcomes and determine the association of these trajectory subgroups with the subsequent development of AF.
Of the 15,792 participants in the ARIC study, 15,410 (26% black; 45% men) were included in the analyses. The analysis for aim No. 1 included 2,456 participants with AF diagnosed during follow-up and a control group of 6,414 participants without AF. Analysis from aim No. 2 included 10,559 participants who had risk factors measured at the first four visits and who were without AF at visit four.
In aim No. 1, Norby and colleagues detected an increased prevalence of all CV risk factors before AF diagnosis, particularly for obesity, smoking and HF more than 15 years before diagnosis (P < .05 for all).
Although prevalence of hypertension and diabetes consistently increased with time before and after AF diagnosis, prevalence of smoking and obesity declined after diagnosis. Incidences of HF, stroke and MI, however, were lower 10 or more years before diagnosis but began to significantly increase in the time period closer to diagnosis. In the control group, incidences of HF, stroke and MI remained low.
The researchers calculated the odds of having HF around 10 years before AF diagnosis are approximately 50% lower than the odds of having HF at the time of diagnosis. For diabetes and hypertension, the odds 10 years before AF diagnosis are only about 20% lower than at time of diagnosis, they wrote.
For aim No. 2, the researchers identified five distinct trajectories for BMI, obesity and systolic BP and four distinct trajectories for hypertension, smoking, diabetes, HF, MI and stroke.
“In this large population-based study, we report an increased prevalence of [CV] risk factors in AF patients [older than] 15 years before their diagnosis,” the researchers wrote. “We also found diverse trajectories in the prevalence of risk factors and [CV] outcomes, suggesting that they could have different roles in the pathogenesis of AF.” – by Tracey Romero
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts