New atrial fibrillation associated with a high risk of major cardiovascular outcomes

A new diagnosis of atrial fibrillation (AF) is associated with a 3.5-fold increase in risk of major adverse cardiac events and an 8.6-fold increase in heart failure hospitalisation in patients with coronary artery or peripheral artery disease, according to data from COMPASS.

Dr Alexander Benz (Population Health Research Institute, Canada) and colleagues aimed to determine risk factors for developing AF and determine the association between new AF and negative outcomes such as major adverse cardiovascular events and hospitalisation due to heart failure [1]. Their analysis was based on data from the COMPASS trial (NCT01776424) cohort, which included participants with coronary artery disease and peripheral artery disease [2]. New AF was diagnosed in 655 (2.4%) participants out of 27,395 enrolled in COMPASS [1].

In multivariate analyses, factors associated with developing AF included advanced age, male sex, body mass index, White race, heart failure, increased systolic blood pressure, and prior myocardial infarction. Diastolic blood pressure, diabetes mellitus, creatinine clearance, smoking, and alcohol consumption were not associated with a new diagnosis of AF.

Furthermore, a new diagnosis of AF was associated with an increased risk of cardiovascular death, stroke, or myocardial infarction (8.8 vs 2.4 events/100 patient-years for participants without AF; HR 3.66; 95% CI 2.81–4.75). Participants with a new AF diagnosis were also at increased risk of hospitalisation due to heart failure (6.8 vs 0.8 events/100 patient-years; HR 8.64; 95% CI 6.31–11.83).

In conclusion, “we can identify 7 common risk factors for a new diagnosis of AF” in participants with stable vascular disease, said Dr Benz. Moreover, a new diagnosis of AF was found to be associated with a marked increase in adverse outcomes.

1. 
   
   1. Benz AP, et al. Clinical significance of new-onset atrial fibrillation in patients with coronary artery or peripheral artery disease: results from the COMPASS trial. Atrial fibrillation: clinical 1. EHRA Congress 2024, 7–9 April, Berlin, Germany.
   2. Eikelboom JW, et al. N Engl J Med 2017;377(14):1319-1330.

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Posted on 29 April, 202429 April, 2024