Incidence and Risk Assessment for Atrial Fibrillation at 5 Years: Hypertensive Diabetic Cohort
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Setting and Study Population
2.3. Research Ethics
2.4. Study Variables
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Independent Prognostic Factors for New AF
3.3. Risk Score for New Atrial Fibrillation (AF) (Prognostic Index, PI)
- Q1 (PI ≤ 6.88). Lowest risk group for AF: ID rate 2.95/1000 people/years (95% CI 1.69–4.80).
- Q2 (PI 6.89 ≤ 7.71). Median-low risk group for AF: ID rate 8.85/1000 people/years (95% CI 6.54–11.70).
- Q3 (PI 7.72 ≤ 8.39). Median-high risk group for AF: ID rate 15.70/1000 people/years (95% CI 12.47–19.52).
- Q4 (PI > 8.39). Highest risk group for AF: ID rate 22.45/1000 people/years (95% CI 18.41–27.10).
4. Discussion
4.1. Main Findings
4.2. Interpretation of the Study Results
4.3. Strengths and Limitations
5. Conclusions
6. Patents
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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No AF a | AF a | pb | |
---|---|---|---|
N (%) | 7809 (94.8%) | 428 (5.2%) | <0.001 |
Average time tracking (years) ( ± ds c) | 4.89 ± 0.71 | 4.61 ± 1.08 | <0.001 |
Age (years) ( ± ds) | 77.83 ± 12.01 | 81.36 ± 8.59 | <0.001 |
Women n (%) | 3856 (49.4%) | 178 (41.6%) | 0.001 |
Weight (kg) ( ± ds) | 81.04 ± 16.18 | 84.15 ± 16.98 | 0.005 |
BMI d (kg/m2) ( ± ds) | 31.10 ± 5.62 | 32.12 ± 5.77 | 0.010 |
Systolic blood pressure (mmHg) ( ± ds) | 138.87 ± 14.32 | 140.02 ± 14.66 | 0.127 |
Diastolic blood pressure (mmHg) ( ± ds) | 76.23 ± 8.65 | 74.71 ± 8.9 | 0.001 |
Hypercholesterolemia n (%) | 2237 (28.6%) | 128 (29.9%) | 0.583 |
Heart rate (bpm) | 75.70 ± 11.45 | 72.44 ± 10.77 | 0.001 |
HbA1c e n (%) | 7.09 ± 1.26 | 6.95 ± 1.07 | 0.035 |
Myocardial infarction n (%) | 185 (2.4%) | 6 (1.4%) | 0.247 |
Peripheral vascular disease n (%) | 323 (4.1%) | 29 (6.8%) | 0.013 |
Valvular disease n (%) | 232 (3%) | 22 (5.1%) | 0.02 |
Heart failure n (%) | 186 (2.4%) | 9 (2.1%) | 0.87 |
Thromboembolism n (%) | 73 (0.9%) | 1 (0.2%) | 0.185 |
CHA2DS2VASc f ( ± ds) | 4.03 ± 0.99 | 4.26 ± 0.83 | 0.005 |
Chronic renal insufficiency n (%) | 249 (3.2%) | 20 (4.7%) | 0.094 |
Dementia n (%) | 203 (2.6%) | 7 (1.6%) | 0.278 |
Insulin n (%) | 1221 (15.6%) | 76 (17.8%) | 0.246 |
Oral antidiabetic’s n (%) | 5164 (66.1%) | 338 (79%) | <0.001 |
Beta-blockers n (%) | 1383 (17.7%) | 112 (26.2%) | <0.001 |
Calcium antagonist’s n (%) | 1511 (19.3%) | 124 (29%) | <0.001 |
ACE inhibitors-ARBs g (%) | 5188 (66.4%) | 353 (82.5%) | <0.001 |
Diuretics n (%) | 1961 (25.1%) | 154 (36%) | <0.001 |
CHA₂DS₂VASc | Number of Patients | Number of AF | ID a Total (95% Confidence Interval, CI) | ID Men | ID Women | pb |
---|---|---|---|---|---|---|
0 | 0 | 0 | 0 | 0 | 0 | |
1 | 0 | 8 | 0 | 0 | 0 | |
2 | 693 | 6 | 2.31(1.0–4.26) | 2.31 | 0 | |
3 | 1533 | 62 | 8.21 (6.30–10.53) | 10.8 | 1.05 | <0.001 |
4 | 2988 | 183 | 12.77 (10.99–14.77) | 16.09 | 4.7 | <0.001 |
5 | 2792 | 161 | 12.18 (10.37–14.21) | 113.9 | 1.56 | <0.001 |
6 | 221 | 12 | 11.7 (6.07–20.53) | 0 | 11.7 | |
7 | 10 | 2 | 40 (4.84–144.50) | 0 | 40 | |
8 | 0 | 0 | 0 | 0 | 0 | |
9 | 0 | 0 | 0 | 0 | 0 |
HR a | 95% CI b | pc | |
---|---|---|---|
Gender | |||
Men | 1 | ||
Women | 0.55 | 0.37–0.82 | 0.004 |
Age | 1.07 | 1.05–1.09 | <0.001 |
Weight | 1.03 | 1.02–1.04 | <0.001 |
Heart rate | 0.98 | 0.97–0.99 | <0.001 |
CHA₂DS₂VASc | 1.57 | 1.16–2.13 | 0.003 |
ID a /1000/People/Years | Q1 | Q2 | Q3 | Q4 | All |
---|---|---|---|---|---|
MEN | |||||
Atrial Fibrillation (95% CI) | 3.8 (2.1–6.2) | 12.4 (8.9–16.7) | 24.4 (18.6–31.4) | 37.6 (25.0–54.4) | 13.7 (11.6–16.1) |
NNS b | 53 | 16 | 9 | 6 | 15 |
Stroke (95% CI) | 0.3 (0.0–1.4) | 0.9 (0.2–2.6) | 1.6 (0.4–4.2) | 8.1 (3.0–17.6) | 1.3 (0.7–2.2) |
WOMEN | |||||
Atrial Fibrillation (95% CI) | 0.7 (0.0–3.9) | 3.3 (1.3–6.7) | 7.4 (4.5–11.5) | 19.7 (15.6–24.5) | 10.4 (8.6–12.6) |
NNS b | 284 | 60 | 27 | 10 | 20 |
Stroke (95% CI) | - | 0.5 (0.0–2.6) | 0.4 (0.0–2.1) | 2.7 (1.4–4.8) | 1.3 (0.7–2.2) |
IQR c limits | ≤6.88 | ≤7.71 | ≤8.39 | >8.39 | |
Atrial Fibrillation (95% CI) | 3.0 (1.7–4.5) | 8.9 (6.5–11.7) | 15.5 (12.3–19.3) | 22.5 (18.4–27.1) | 12.1 (10.7–13.7) |
NNS b | 67 | 22 | 13 | 9 | 17 |
Stroke (95% CI) | 0.2 (0.0–1.0) | 0.7 (0.2–1.9) | 1.0 (0.3–2.3) | 3.5 (2.1–5.7) | 1.3 (0.9–1.9) |
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Muria-Subirats, E.; Clua-Espuny, J.L.; Ballesta-Ors, J.; Lorman-Carbo, B.; Lechuga-Duran, I.; Fernández-Saez, J.; Pla-Farnos, R.; on behalf members of AFRICAT Group. Incidence and Risk Assessment for Atrial Fibrillation at 5 Years: Hypertensive Diabetic Cohort. Int. J. Environ. Res. Public Health 2020, 17, 3491. https://doi.org/10.3390/ijerph17103491
Muria-Subirats E, Clua-Espuny JL, Ballesta-Ors J, Lorman-Carbo B, Lechuga-Duran I, Fernández-Saez J, Pla-Farnos R, on behalf members of AFRICAT Group. Incidence and Risk Assessment for Atrial Fibrillation at 5 Years: Hypertensive Diabetic Cohort. International Journal of Environmental Research and Public Health. 2020; 17(10):3491. https://doi.org/10.3390/ijerph17103491
Chicago/Turabian StyleMuria-Subirats, Eulalia, Josep Lluis Clua-Espuny, Juan Ballesta-Ors, Blanca Lorman-Carbo, Iñigo Lechuga-Duran, Jose Fernández-Saez, Roger Pla-Farnos, and on behalf members of AFRICAT Group. 2020. "Incidence and Risk Assessment for Atrial Fibrillation at 5 Years: Hypertensive Diabetic Cohort" International Journal of Environmental Research and Public Health 17, no. 10: 3491. https://doi.org/10.3390/ijerph17103491