Does atrial fibrillation still increase the risk of death? One-year follow-up results of the NOMED-AF study.
Pol Arch Intern Med
; 134(3)2024 03 27.
Article
em En
| MEDLINE
| ID: mdl-38164644
ABSTRACT
INTRODUCTION:
Although atrial fibrillation (AF) is a wellknown risk factor for ischemic stroke and hospitalization, its effect on mortality has not been clearly established.OBJECTIVES:
We aimed to assess whether AF is an independent risk factor for death. A secondary objective was to evaluate the role of oral anticoagulation in the prevention of stroke and death in 1year followup of patients included in the NOMEDAF (Noninvasive Monitoring for Early Detection of Atrial Fibrillation) study. PATIENTS ANDMETHODS:
The NOMEDAF study included 3014 patients. The participants underwent continuous longterm electrocardiographic monitoring using a wearable vest for up to 30 days. The present analysis involved 2795 patients who completed the 1year followup. The median (interquartile range) followup time was 365 (365-365) days. AF was diagnosed in 617 participants.RESULTS:
Independent risk factors for death in the patients who completed the 1year followup were AF, age equal to or above 65 years, and chronic kidney disease. The individuals with diagnosed AF had an almost 2fold higher risk of death (odds ratio [OR], 1.7; 95% CI, 1.18-2.44; P <0.001) and a 2.5fold higher risk of stroke (OR, 2.53; 95% CI, 1.41-4.44; P <0.001), as compared with those without an AF diagnosis. The participants with AF who received oral anticoagulants had an almost 5fold lower risk of death than those who were not on anticoagulation (2.9% vs 14.2%, respectively; P <0.001).CONCLUSIONS:
AF is an independent risk factor for death and cardiovascular hospitalization. The risk of death and stroke in patients with AF is significantly higher than in the patients without this arrhythmia. Oral anticoagulation in patients with AF significantly reduces the rates of death and stroke; however, its use is suboptimal in this group of patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Acidente Vascular Cerebral
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article