Supervisors info:
Κυρίτση Ελένη, Καθηγήτρια, Τμήμα Νοσηλευτικής, Πανεπιστήμιο Δυτικής Αττικής
Τούσουλης Δημήτριος, Καθηγητής, Τμήμα Ιατρικής, ΕΚΠΑ
Τούτουζας Κωνσταντίνος, Καθηγητής, Τμήμα Ιατρικής, ΕΚΠΑ
Summary:
Introduction: Atrial Fibrillation (AF) is the most common, sustained, arrhythmia in clinical practice. AF is traditionally associated with thromboembolic events, especially ischemic stroke or transient ischemic attack (TIA), congestive heart failure and tachycardia-induced cardiomyopathy, resulting in increased morbidity and mortality. Discovering a way to predict the recurrence of AF in patients with paroxysmal/persistent AF may improve the quality of those patients’ lives, preventing the above mentioned events, and may decrease hospital re-admissions and, consequently, health care costs.
Purpose: The aim of this current study was to assess those clinical factors that could predict AF recurrences, in patients with paroxysmal or persistent AF.
Methods: In this post-hoc analysis of the MISOAC-AF trial, consecutive patients with concomitant AF, being admitted to the Cardiology Department of a tertiary hospital for any reasons, were retrospectively analyzed. The only exclusion criteria was permament AF. We tried to associate their baseline demographics, medical history, medication, laboratory and echocardiographic values with the endpoint value of this study, the AF recurrence.
Results: Out of 1140 AF patients, 414 fulfilling eligibility criteria were analyzed for a median follow-up of three years. They were mostly men, with a median age of 72.1 years, body mass index of 28.2kg/m2 and median 7 days of hospitalization. Only 40 patients had AF recurrence during the first year of follow-up. From the univariate analysis, increased age (HR 1.174, 95% CI: 0.996¬-1.086, p-value: 0,044), increased left atrial volume (HR 1.061, 95% CI: 0.951-1.171, p-value: <0,001), reduced left ventricle ejection fraction HR 0.951, 95% CI: 0.9¬-1.086, p-value: 0,042), increased CHADS2VASc score (HR 1.190, 95% CI: 0.7676¬-1.086, p-value: 0,047) and anti-arrhythmic drugs at discharge (HR 1.951, 95% CI: 0.995¬-3.860, p-value: 0,052) were associated with AF recurrence. However, after the multivariate analysis only increased left atrial volume (HR 1.036 95% CI: 0.997-1.076, p-value 0.022) and increased CHADS2VASc score (HR 1.054 95% CI: 0.794-1.359, p-value: 0.039) were statistically significant factors for AF recurrence.
Conclusions: Among hospitalized patients with paroxysmal or persistent AF, the factors associated with AF recurrence, are increased left atrial volume and increased CHADS2VASc score.
Keywords:
Atrial fibrillation, Paroxysmal, Persistent, Recurrence, Prevention
