Risk Factors for the Development of New-Onset Persistent Atrial Fibrillation: Subanalysis of the VITAL Study.

Middeldorp, Melissa E; Sandhu, Roopinder K; Mao, Jessica; Gencer, Baris; Danik, Jacqueline S; Moorthy, Vinayaga; Cook, Nancy R; Albert, Christine M (2023). Risk Factors for the Development of New-Onset Persistent Atrial Fibrillation: Subanalysis of the VITAL Study. Circulation. Arrhythmia and electrophysiology, 16(12), pp. 651-662. Lippincott Williams & Wilkins 10.1161/CIRCEP.123.012334

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BACKGROUND

Sustained forms of atrial fibrillation (AF) are associated with lower treatment success rates and poorer prognosis compared with paroxysmal AF. Yet, little is known about risk factors that predispose to persistent AF on initial presentation. Our objective was to define risk factors associated with new-onset persistent AF.

METHODS

We prospectively examined the differential associations between lifestyle, clinical, and socioeconomic risk factors and AF pattern (persistent versus paroxysmal) at the time of diagnosis among 25 119 participants without a history of cardiovascular disease, AF, or cancer in the VITAL rhythm study (Vitamin D and Omega-3).

RESULTS

During a median follow-up of 5.3 years, 900 participants developed AF and 346 (38.4%) were classified as persistent at the time of diagnosis. In multivariable competing risk models, increasing age, male sex, White race, height, weight, body mass index ≥30 kg/m2, hypertension, current or past smoking, alcohol intake ≥2 drinks/day, postcollege education, and randomized treatment with vitamin D were significantly associated with incident persistent AF. Compared with paroxysmal AF, increasing age, male sex, weight, body mass index ≥30 kg/m2, and postcollege education were more strongly associated with persistent AF in multivariable models regardless of whether interim cardiovascular disease and heart failure events were censored.

CONCLUSIONS

In a prospective cohort without baseline AF or cardiovascular disease, over one-third of AF at the time of diagnosis is persistent. Older age, male sex, postcollege education, and obesity were preferentially associated with persistent AF and represent a high-risk AF subset for population-based intervention.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Gencer, Baris Faruk

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1941-3084

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Pubmed Import

Date Deposited:

29 Nov 2023 15:49

Last Modified:

04 Jan 2024 14:58

Publisher DOI:

10.1161/CIRCEP.123.012334

PubMed ID:

38018439

Uncontrolled Keywords:

atrial fibrillation humans life style risk factors stroke

BORIS DOI:

10.48350/189552

URI:

https://boris.unibe.ch/id/eprint/189552

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