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Atrial Fibrillation in Patients With Cardiomyopathy: Prevalence and Clinical Outcomes From Real-World Data

Buckley, BJR, Harrison, SL, Gupta, D, Fazio-Eynullayeva, E, Underhill, P and Lip, GYH (2021) Atrial Fibrillation in Patients With Cardiomyopathy: Prevalence and Clinical Outcomes From Real-World Data. Journal of the American Heart Association, 10 (23). ISSN 2047-9980

Buckley et al 2021 JAHA.121.021970.pdf - Published Version
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BACKGROUND: Cardiomyopathy is a common cause of atrial fibrillation (AF) and may also present as a complication of AF. However, there is a scarcity of evidence of clinical outcomes for people with cardiomyopathy and concomittant AF. The aim of the present study was therefore to characterize the prevalence of AF in major subtypes of cardiomyopathy and investigate the impact on important clinical outcomes. METHODS AND RESULTS: A retrospective cohort study was conducted using electronic medical records from a global federated health research network, with data primarily from the United States. The TriNetX network was searched on January 17, 2021, including records from 2002 to 2020, which included at least 1 year of follow-up data. Patients were included based on a diagnosis of hypertrophic, dilated, or restrictive cardiomyopathy and concomitant AF. Patients with cardiomyopathy and AF were propensity-score matched for age, sex, race, and comorbidities with patients who had a cardiomyopathy only. The outcomes were 1-year mortality, hospitalization, incident heart failure, and incident stroke. Of 634 885 patients with cardiomyopathy, there were 14 675 (2.3%) patients with hypertrophic, 90 117 (7.0%) with restrictive, and 37 685 (5.9%) with dilated cardiomyopathy with concomitant AF. AF was associated with significantly higher odds of all-cause mortality (odds ratio [95% CI]) for patients with hypertrophic (1.26 [1.13–1.40]) and dilated (1.36 [1.27–1.46]), but not restrictive (0.98 [0.94–1.02]), cardiomyopathy. Odds of hospitalization, incident heart failure, and incident stroke were significantly higher in all cardiomyopathy subtypes with concomitant AF. Among patients with AF, catheter ablation was associated with significantly lower odds of all-cause mortality at 12 months across all cardiomyopathy subtypes. CONCLUSIONS: Findings of the present study suggest AF may be highly prevalent in patients with cardiomyopathy and associated with worsened prognosis. Subsequent research is needed to determine the usefulness of screening and multisdisciplinary treatment of AF in this population.

Item Type: Article
Uncontrolled Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; atrial fibrillation; cardiomyopathy; comorbidity; MACE; preventive cardiology; secondary prevention; CATHETER ABLATION; HYPERTROPHIC CARDIOMYOPATHY; SYSTOLIC DYSFUNCTION; HEART-FAILURE; MORBIDITY; RISK; Humans; Atrial Fibrillation; Cardiomyopathies; Prognosis; Prevalence; Retrospective Studies; Female; Male; MACE; atrial fibrillation; cardiomyopathy; comorbidity; preventive cardiology; secondary prevention; Atrial Fibrillation; Cardiomyopathies; Female; Humans; Male; Prevalence; Prognosis; Retrospective Studies; 1102 Cardiorespiratory Medicine and Haematology
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: American Heart Association
SWORD Depositor: A Symplectic
Date Deposited: 12 May 2022 10:44
Last Modified: 12 May 2022 10:45
DOI or ID number: 10.1161/JAHA.121.021970
URI: https://researchonline.ljmu.ac.uk/id/eprint/16818
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