Real-Life Incident Atrial Fibrillation in Outpatients with Coronary Artery Disease

Ninni, Sandro; Lemesle, Gilles; Meurice, Thibaud; Tricot, Olivier; Lamblin, Nicolas; Bauters, Christophe

Type de document :

Article dans une revue scientifique: Article original

DOI :

10.3390/jcm9082367

Titre :

Real-Life Incident Atrial Fibrillation in Outpatients with Coronary Artery Disease

Auteur(s) :

Ninni, Sandro [Auteur]

Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 [RNMCD]
Lemesle, Gilles [Auteur]

Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials [FACT]
Institut Coeur Poumon [CHU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Meurice, Thibaud [Auteur]
Tricot, Olivier [Auteur]
Lamblin, Nicolas [Auteur]

Early Markers of Cardiovascular Remodeling in Valvulopathy and Heart Failure [CHU Rouen] [FHU REMOD-VHF ]
Institut Coeur Poumon [CHU Lille]
Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]
Bauters, Christophe [Auteur]

Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 [RID-AGE]

Titre de la revue :

Journal of clinical medicine

Pagination :

2367

Éditeur :

MDPI

Date de publication :

2020-08

ISSN :

2077-0383

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background: The risk, correlates, and consequences of incident atrial fibrillation (AF) in patients with chronic coronary artery disease (CAD) are largely unknown. Methods and results: We analyzed incident AF during a ...
Lire la suite >Background: The risk, correlates, and consequences of incident atrial fibrillation (AF) in patients with chronic coronary artery disease (CAD) are largely unknown. Methods and results: We analyzed incident AF during a 3-year follow-up in 5031 CAD outpatients included in the prospective multicenter CARDIONOR registry and with no history of AF at baseline. Incident AF occurred in 266 patients (3-year cumulative incidence: 4.7% (95% confidence interval (CI): 4.1 to 5.3)). Incident AF was diagnosed during cardiology outpatient visits in 177 (66.5%) patients, 87 of whom were asymptomatic. Of note, 46 (17.3%) patients were diagnosed at time of hospitalization for heart failure, and a few patients (n = 5) at the time of ischemic stroke. Five variables were independently associated with incident AF: older age (p < 0.0001), heart failure (p = 0.003), lower left ventricle ejection fraction (p = 0.008), history of hypertension (p = 0.010), and diabetes mellitus (p = 0.033). Anticoagulant therapy was used in 245 (92%) patients and was associated with an antiplatelet drug in half (n = 122). Incident AF was a powerful predictor of all-cause (adjusted hazard ratio: 2.04; 95% CI: 1.47 to 2.83; p < 0.0001) and cardiovascular mortality (adjusted hazard ratio: 2.88; 95% CI: 1.88 to 4.43; p < 0.0001). Conclusions: In CAD outpatients, real-life incident AF occurs at a stable rate of 1.6% annually and is frequently diagnosed in asymptomatic patients during cardiology outpatient visits. Anticoagulation is used in most cases, often combined with antiplatelet therapy. Incident AF is associated with increased mortality.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Collections :