Cause of Death and Associated Factors in Elderly Patients With Atrial Fibrillation　― Long-Term Retrospective Study ―

Abstract

Against this background, the present study investigated differences in the clinical characteristics, prescription of OACs, incidence of death, and cause of death in elderly AF patients, and evaluated whether OACs and comorbidities are independently associated with prognosis in these patients. Methods Study Patients and Data Collection The present study was a hospital-based retrospective observational study. All patients with AF (paroxysmal or sustained) as of 2017 according to the electronic medical record (EMR) system were picked up from 1997. Cardiologists and biomedical engineers reviewed the electrocardiograms (ECGs) and medical records, and ECG-documented A trial fibrillation (AF) is a common arrhythmia in elderly patents. The prevalence and incidence rate of AF increase with age, with more than 70% of those diagnosed with AF being ≥65 years of age. 1,2 Although comorbidities increase with age, 3 elderly AF patients are likely to have a greater number of comorbidities. 2,4,5 The risk of developing embolic events is 5-fold higher in patients with AF than in those with sinus rhythm, 6 leaving patients bedridden or requiring long-term care, and increasing the mortality rate. 7 Oral anticoagulants (OACs) significantly reduce the incidence of stroke in patients with AF. Allcause mortality and causes of death among patients with AF were recently examined in both randomized control trials 8 and in cohort studies. 9-12 The real-world cohort studies demonstrated that stroke-related deaths account for approximately 5-8% of all-cause deaths, with non-cardio

Impact of preexisting diabetes mellitus on cardiovascular and all-cause mortality in patients with atrial fibrillation: A meta-analysis

“…The association of diabetes mellitus with all-cause mortality was reported in 19 studies ( 8 – 11 , 14 , 15 , 17 – 24 , 26 – 30 ). A random-effects model meta-analysis indicated that diabetes mellitus was associated with an increased risk of all-cause mortality (RR 1.37; 95% CI 1.23–1.53; I 2 = 95.1%, p < 0.001; Figure 3 ) compared with those without diabetes.…”

“…The included studies were published between 2011 and 2022. Three studies ( 19 , 21 , 27 ) were post-hoc analyses of randomized controlled trials, five studies ( 11 , 14 , 17 , 26 , 28 ) were retrospective designs, and others were prospective studies. Sample sizes ranged between 278 and 326,832, with 526,136 atrial fibrillation patients.…”

“…Ten studies (9,15,16,19,20,(24)(25)(26)(27)29) provided data on the association of diabetes mellitus with cardiovascular mortality. A fixed-effects model meta-analysis suggested that diabetes mellitus was associated with an increased risk of cardiovascular mortality (RR 1.46; 95% CI 1.34-1.58; I 2 = 0%, p = 0.594; Figure 4) compared with those without diabetes.…”

Contemporary survival and anticoagulation of patients with atrial fibrillation: A community based cohort study in China

“…It's controversial whether sustained AF was associated with higher mortality than paroxysmal AF ( 10 , 11 , 14 , 15 ). This study indicated permanent AF was independently associated with an increased risk of all-causeortality and non-cardiovascular mortality, but not cardiovascular mortality.…”

“…Such correlation needs more research to verify in the future. Some studies indicated OAC use was independently associated with a lower risk of all-cause mortality and cardiovascular mortality ( 10 , 11 , 14 , 15 ). However, our study did not show this correlation, and it may be attributed to the very low rate of anticoagulant therapy at baseline.…”