scholarly journals Reflections on CABANA Trial (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation Trial)

2019 ◽  
Vol 32 (2) ◽  
pp. 73-75
Author(s):  
José Tarcísio Medeiros de Vasconcelos
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Survival Data ◽  
Large Population ◽  
Public Health Problem ◽  
Antiarrhythmic Drug Therapy ◽  
Heart Study ◽  
Population Survival ◽  
Obesity Hypertension ◽  
Atrial Fibrillation Trial

Atrial fibrillation has been consolidated in recent decades as a serious public health problem, considering its notorious increase in prevalence with aging combined with increased population survival. Data from the Framingham Heart Study indicate that, even in an optimal scenario of absence of classic risk factors for its occurrences, such as smoking, alcohol abuse, obesity, hypertension, diabetes, and heart disease, about 10% of individuals aged 80 or over and about 25% of those aged 90 or over will have atrial fibrillation. These rates substantially increase when added to single or combined risk factors. Despite its already well-known association with the occurrence of thromboembolic stroke, the presence of atrial fibrillation has been identified as an independent mortality risk factor in large population studies.

scholarly journals Reflexões sobre o estudo CABANA (Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation Trial)

2019 ◽  
Vol 32 (2) ◽  
pp. 73-75 ◽  
Author(s):  
José Tarcísio Medeiros de Vasconcelos
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Catheter Ablation ◽  
Antiarrhythmic Drug ◽  
Framingham Heart Study ◽  
Antiarrhythmic Drug Therapy ◽  
Heart Study ◽  
Atrial Fibrillation Trial

A fibrilação atrial se consolidou nas últimas décadas como um grave problema de saúde pública, considerando o seu notório aumento de prevalência com o envelhecimento aliado ao aumento da sobrevida da população. Dados do Framingham Heart Study indicam que, mesmo em um cenário ótimo de ausência dos clássicos fatores de risco para sua ocorrência, como tabagismo, consumo abusivo de álcool, obesidade, hipertensão, diabetes e cardiopatia, cerca de 10% dos indivíduos com idade igual ou superior a 80 anos e algo em torno de 25% daqueles com idade igual ou superior a 90 anos terão fibrilação atrial1. Essas taxas aumentam substancialmente quando se agregam a fatores de risco isolados ou combinados. A despeito da sua já bem conhecida relação com a ocorrência do acidente vascular encefálico trombo-embólico2, a presença de fibrilação atrial tem sido identificada como um fator de risco de mortalidade independente em grandes estudos populacionais3.

scholarly journals 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study

The Lancet ◽  
2015 ◽  
Vol 386 (9989) ◽  
pp. 154-162 ◽  
Author(s):  
Renate B Schnabel ◽  
Xiaoyan Yin ◽  
Philimon Gona ◽  
Martin G Larson ◽  
Alexa S Beiser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Framingham Heart Study ◽  
Heart Study ◽  
Incidence Risk

scholarly journals Atrial fibrillation: A review of modifiable risk factors and preventive strategies

2019 ◽  
Vol 57 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Alireza Sepehri Shamloo ◽  
Nikolaos Dagres ◽  
Arash Arya ◽  
Gerhard Hindricks
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Underlying Mechanism ◽  
Modifiable Risk Factors ◽  
Preventive Strategies ◽  
Mortality And Morbidity ◽  
Obstructive Sleep ◽  
Obesity Hypertension ◽  
Development And Management

Abstract Atrial fibrillation (AF), as the most common cardiac arrhythmia worldwide, is associated with increased mortality and morbidity. Successful therapeutic strategies have been introduced so far, but they are associated with significant costs. Therefore, identification of modifiable risk factors of AF and the development of appropriate preventive strategies may play a substantial role in promoting community health and reducing health care system costs. Modifiable cardiovascular risk factors including obesity, hypertension, diabetes mellitus, obstructive sleep apnea, alcohol consumption, smoking, and sedentary lifestyles have been proposed as possible contributors to the development and progression of AF. In this review, we discuss the role of modifiable risk factors in the development and management of AF and the evidence for the underlying mechanism for each of the potential risk factor.

Abstract P003: Trajectories of Cardiovascular Risk Factors / Outcomes and Atrial Fibrillation in a 25 Year Follow-up: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Faye L Lopez ◽  
Sunil K Agarwal ◽  
Elsayed Z Soliman ◽  
Lin Y Chen ◽  
Lindsay G Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Index Date ◽  
Reference Group ◽  
Large Population ◽  
Population Based ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Little attention has been devoted to the timing of risk factor development in relation to atrial fibrillation (AF) diagnosis. We assessed the long term trajectories of risk factors and cardiovascular (CV) outcomes in the Atherosclerosis Risk in Communities (ARIC) study, a US community-based cohort. Methods: Our analysis included 2134 individuals with incident AF and 5674 controls matched with cases 1:3 on age, sex, race and center, participating in the ARIC study. Information on incident AF and risk factors / CV outcomes (obesity, hypertension, smoking, diabetes, heart failure (HF), myocardial infarction (MI), and stroke) was obtained during 5 study exams between 1987 and 2013, and surveillance of CV events through 2010. The prevalence of risk factors / CV outcomes in the period before and after the diagnosis of AF (and the corresponding index date for controls) was modeled using general estimating equations models. Adjusted odds ratios (OR) of risk factors / CV outcomes were calculated, using the index date ±2.5 years as the reference group. The interaction of time with AF was used to compare differences in trajectories. Results: During a median follow-up of 24 years, we observed diverse trajectories in the prevalence of risk factors and CV outcomes among AF patients, with steep increases in the prevalence of stroke, MI and HF during the period close to AF diagnosis, while trajectories for hypertension and diabetes showed monotonic increases, and those for smoking and obesity suggested decreases in prevalence after AF diagnosis (Figure A). The trajectories over time for hypertension, obesity, HF, stroke and MI were significantly different based on AF status, with lower increments among those without AF (Figure A and B). Conclusion: In this large population-based study, trajectories in the odds of risk factors and CV outcomes were diverse, suggesting they could have different roles in the pathogenesis of AF. The prevalence of CV outcomes increased after AF diagnosis, and trajectories differed by AF status.

scholarly journals Trajectories of Risk Factors and Risk of New-Onset Atrial Fibrillation in the Framingham Heart Study

Hypertension ◽  
2016 ◽  
Vol 68 (3) ◽  
pp. 597-605 ◽  
Author(s):  
Faisal Rahman ◽  
Xiaoyan Yin ◽  
Martin G. Larson ◽  
Patrick T. Ellinor ◽  
Steven A. Lubitz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Framingham Heart Study ◽  
Heart Study ◽  
Onset Atrial Fibrillation ◽  
New Onset

scholarly journals Modifiable risk factors predict incident atrial fibrillation and heart failure

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001092
Author(s):  
Jorge A Wong ◽  
David Conen ◽  
Jeff S Healey ◽  
Linda S B Johnson
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Population Attributable Risk ◽  
Population Based ◽  
Modifiable Risk Factors ◽  
Current Cigarette Smoking ◽  
Cox Models ◽  
Risk Factor Modification ◽  
Obesity Hypertension

ObjectiveHeart failure (HF) frequently complicates atrial fibrillation (AF) and significantly increases mortality risk. Limited data exist on the modifiable risk factors associated with development of HF in AF patients.MethodsWe examined two large, prospective, population-based cohorts without prior AF or HF at baseline: Malmö Preventive Project (MPP, n=32 625) and Malmö Diet and Cancer Study (MDCS, n=27 695). Using Lunn-McNeil competing risks, multivariable Cox models were constructed to determine hazard ratios (HR) and 95% confidence intervals (CI) of risk factors for incident HF with AF, and AF alone.ResultsMean follow-up in MPP and MDCS was 27.6±8.4 and 17.7±5.3 years. In MPP, body mass index (HR 1.11, 95% CI 1.09 to 1.13 vs HR 1.05, 95% CI 1.04 to 1.06 per kg/m2), systolic blood pressure (HR 1.20, 95% CI 1.24 to 1.26 vs HR 1.08, 95% CI 1.06 to 1.10 per 10 mm Hg) and current cigarette smoking (HR 1.73, 95% CI 1.54 to 1.95 vs HR 1.23, 95% CI 1.15 to 1.32) had stronger associations with incident AF with HF compared with AF alone (all p for difference <0.0001). Similar results were observed in MDCS (all p for difference <0.009). These three risk factors and diabetes accounted for 51.8% and 54.1% of the population attributable risk (PAR) for AF with HF in MPP and MDCS, respectively, compared with 20.1% and 27.0% for AF alone.ConclusionsObesity, hypertension and active smoking preferentially associated with AF with HF, compared with AF alone, and accounted for >50% of the PAR. Randomised trials are needed to assess whether risk factor modification can reduce the incidence of AF with HF and reduce mortality.

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