Risk of Atrial Fibrillation in Patients with Congenital Heart Disease: Results of a Propensity Score-Matched, Nationwide Cohort Study

Hu, Wei‐Syun; Lin, Cheng‐Li

doi:10.5551/jat.48835

Cited by 8 publications

(7 citation statements)

References 21 publications

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“… 15 AF was more common in aging patients with CHD 20 21 and the incidence rate of AF in ACHD was higher for older age groups in Taiwan. 22 In our study, the mean age of the AF group was higher than that of the non-AF, and the proportion of AF became greater with aging in ACHD ( Table 2 ). The common age group of AF with ACHD was 50's to 70's ( Supplementary Fig.…”

Section: Discussionmentioning

confidence: 45%

Impact of Atrial Fibrillation on Survival in Adults with Congenital Heart Disease: a Retrospective Population-based Study

et al. 2021

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Background The number of adults with congenital heart disease (ACHD) with atrial fibrillation (AF) is expected to increase. We sought to assess the impact of AF on survival in Korean ACHD. Methods Records of AF in ACHD were extracted from the records of the Korea National Health Insurance Service from 2006 through 2015. Multiple Cox proportional hazards analyses were carried out after adjustment for age, sex, income level, AF, and comorbidities. Survival rates (SRs) with and without AF were compared. The death records from 2006 through 2016 were included. Results A total of 3,999 ACHD had AF (51.4% were male) and 62,691 ACHD did not have AF (43.5% were male); the proportion of ACHD who were 60 years and older was 53.0% and 27.0% in those with and without AF, respectively ( P < 0.001). The age-standardized incidence rate for AF was 1,842.0 persons per 100,000 people in the Korean general population from 2006 through 2015. For AF in ACHD, it was 5,996.4 persons per 100,000 ACHD during the same period, which was higher than that in the general population ( P < 0.001). Significantly higher proportion of death (20.9%) occurred in ACHD with AF than without AF (8.3%) ( P < 0.001). The adjusted hazard ratio for AF of death in ACHD was 1.39 (95% confidence interval, 1.29–1.50). The ten-year SR of ACHD with AF was 69.7% whereas it was 87.5% in non-AF ( P < 0.001). Conclusion In ACHD, AF occurs more frequently and has a worse prognosis than seen in the non-valvular general population in Korea. AF is associated with increased death in ACHD, especially with aging.

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Section: Discussionmentioning

confidence: 45%

Impact of Atrial Fibrillation on Survival in Adults with Congenital Heart Disease: a Retrospective Population-based Study

et al. 2021

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“…Atrial fibrillation, the most common cardiac arrhythmia in clinical practice, can lead to stroke, heart failure, and other cardiovascular complications 1,2) and consequently contribute to considerably high mortalities 3,4) . Over a million individuals are expected to be affected with atrial fibrillation by 2050 because of population aging in Japan 5,6) .…”

Section: Introductionmentioning

confidence: 99%

Serum High-Sensitivity C-Reactive Protein Levels and the Risk of Atrial Fibrillation in Japanese Population: the Circulatory Risk in Communities Study

Tanaka

Imano

Kubota

et al. 2021

JAT

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Aim: This study aimed to investigate the association between the serum high-sensitivity C-reactive protein (hs-CRP) levels and incident atrial fibrillation risk in the general Japanese population, who have lower hs-CRP levels than the Western population, and assess whether the association is modified by sex, overweight, hypertension, and smoking status. Methods: We conducted a prospective study in 6517 Japanese men and women aged 40–79 years without atrial fibrillation at baseline and enrolled in the Circulatory Risk in Communities Study (2002–2008). The hs-CRP levels were measured using the latex particle-enhanced immunonephelometric assay. Atrial fibrillation was identified using standard 12-lead electrocardiograms and information on physician-diagnosed atrial fibrillation history from the follow-up surveys. We used a Cox proportional hazard regression stratified by community. Results: During a median follow-up of 11 years, 127 new cases of atrial fibrillation (74 and 53 cases among men and women, respectively) were found. Compared to the lowest quintile of hs-CRP levels, the multivariable hazard ratios (95% confidence intervals) were 2.54 (1.17–5.50), 2.28 (1.06–4.93), 2.92 (1.37–6.23), and 2.77 (1.30–5.91) for the second, third, fourth, and fifth (highest) quintiles, respectively. There was no significant effect modification by sex, overweight, hypertension, and smoking status ( P for interaction > 0.05). Conclusions: Elevated hs-CRP levels were significantly associated with increased risk of atrial fibrillation in the Japanese population. The association of hs-CRP levels with incident atrial fibrillation did not vary according to sex, overweight, hypertension status, or smoking status.

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“…Our study suggests the existence of an enormous arrhythmic burden of AF in the aged ccTGA population, which is reported for the first time in our study. It is difficult to elucidate the existence of this phenomenon only by the exponential relationship between age and AF ( 10 ) and by the generally higher AF incidence among CHD patients than non-CHD individuals ( 11 ). One may speculate that it reflects the presence of diastolic dysfunction of the sRV in older patients.…”

Section: Discussionmentioning

confidence: 99%

Systemic right ventricle in elderly patients with congenitally corrected transposition of the great arteries: clinical profile, cardiac biomarkers and echocardiographic parameters

et al. 2020

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Objective: The number of patients with congenitally corrected transposition of the great arteries (ccTGA) surviving to old age is increasing. This study therefore sought to characterize “geriatric” systemic right ventricle (sRV) in terms of clinical profile, cardiac biomarkers, and echocardiography-derived function when compared with findings in younger patients. Methods: A single-center cross-sectional study of adults with ccTGA was performed. Patients underwent clinical assessment; transthoracic echocardiography; and venous blood sampling including N-terminal pro–B-type natriuretic peptide (NTproBNP), galectin-3, and soluble suppression of tumorgenicity 2 (sST2) measurements. In the echocardiographic study, the sRV function was assessed using fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), systolic pulsed-wave Doppler velocity (s′), and longitudinal strain (LS). Results: Ten patients with ccTGA aged 60 years or older and 53 patients younger than 60 years of age were included. There were significantly more individuals with hypertension (40% vs. 5.7%), dyslipidaemia (50% vs. 5.7%), and atrial fibrillation (70% vs. 20.7%) in the older group; similarly, we found higher NTproBNP (2706 pg/mL vs. 784.7 pg/mL; p<0.001), and galectin-3 (10.15 ng/mL vs. 7.24 ng/mL; p=0.007) concentrations in elderly ccTGA individuals, while sST2 content did not vary significantly according to age. Upon echocardiographic assessment, lower sRV FAC (28.6% vs. 36.1%; p=0.028) and LS (−12% vs. −15.5%; p=0.017) values were observed in patients aged 60 years or older. TAPSE and s’ did not differ between the age groups. Conclusion: Careful screening for acquired comorbidities, particularly atrial fibrillation, in elderly ccTGA patients is warranted. Examining selected cardiac biomarkers and echocardiography-derived parameters are useful in the assessment of the aging sRV.

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Risk of Atrial Fibrillation in Patients with Congenital Heart Disease: Results of a Propensity Score-Matched, Nationwide Cohort Study

Cited by 8 publications

References 21 publications

Impact of Atrial Fibrillation on Survival in Adults with Congenital Heart Disease: a Retrospective Population-based Study

Impact of Atrial Fibrillation on Survival in Adults with Congenital Heart Disease: a Retrospective Population-based Study

Serum High-Sensitivity C-Reactive Protein Levels and the Risk of Atrial Fibrillation in Japanese Population: the Circulatory Risk in Communities Study

Systemic right ventricle in elderly patients with congenitally corrected transposition of the great arteries: clinical profile, cardiac biomarkers and echocardiographic parameters

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