Cited by 161Atrial Fibrillation Management and OutcomesAcute Ischemic Stroke ManagementCardiovascular and Diving-Related Complications

Asymptomatic versus symptomatic atrial fibrillation: A systematic review of age/gender differences and cardiovascular outcomes

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Xiong, Qinmei, Proietti, Marco, Senoo, Keitaro, Lip, Gregory Y.H.·2015·International Journal of Cardiology

Abstract

Up to 40% of atrial fibrillation (AF) patients are asymptomatic. Despite this, scarce data are available about asymptomatic AF, with regard to its clinical profile and relationship to cerebrovascular and cardiovascular risks. Our objective was to conduct a systematic review and meta-analysis was to study the relationship between age and gender with asymptomatic AF and to establish whether patients with asymptomatic AF have a higher risk of death (all-cause and cardiovascular) and stroke/systemic thromboembolism, when compared to symptomatic AF patients. After a comprehensive search, 6 studies (2 randomized clinical trials and 4 observational studies) were entered in the meta-analysis. Despite significant heterogeneity, our data show that the prevalence of females amongst asymptomatic AF group was significantly less compared to the symptomatic AF group (RR, 0.57; 95% CI: 0.52-0.64). No difference in age between asymptomatic and symptomatic AF patients (P=0.72) was seen. No differences were found in all-cause death between patients with asymptomatic and symptomatic AF (RR, 1.38; 95% CI: 0.82-2.17), nor in cardiovascular death (RR, 0.85; 95% CI: 0.53-1.36) or stroke/thromboembolism (RR, 1.72 95% CI: 0.59-5.08). Asymptomatic AF is more associated with male sex, irrespective of age. Both general and cardiovascular death risks as well as thromboembolic risk do not seem to be affected by the asymptomatic clinical status. Symptomatic status should not determine our approach to stroke prevention and other cardiovascular prevention therapies, amongst patients with AF.

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Crossref · 10.1016/j.ijcard.2015.05.011

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Authors
Xiong, Q., Proietti, M., Senoo, K., & Lip, G. Y. H.
Affiliations
Birmingham City Hospital (GB)
Corresponding author
Proietti, Marco
Venue
International Journal of Cardiology
Publisher
Elsevier BV
Published
2015-07
Volume
191
Pages
172-177
ISSN
0167-5273 (ISSN-L)
OpenAlex
W1496114842
Cited by
161
References
23
Citations by year
2026: 9 · 2025: 10 · 2024: 15 · 2023: 7 · 2022: 14 · 2021: 28 · 2020: 15 · 2019: 21 · 2018: 7 · 2017: 17 · 2016: 14 · 2015: 4
FWCI
2.40
Type
journal article
Language
en
Locations
  • International Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
Keywords
asymptomatic atrial fibrillation, symptomatic atrial fibrillation, sex differences, age differences, all-cause mortality, cardiovascular mortality, stroke, systemic thromboembolism, stroke prevention, cardiovascular risk
MeSH terms
Age Factors, Atrial Fibrillation, Female, Humans, Male, Sex Characteristics, Randomized Controlled Trials as Topic, Treatment Outcome, Asymptomatic Diseases, Observational Studies as Topic

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