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Incidence of Atrial Fibrillation and Relationship With Cardiovascular Events, Heart Failure, and Mortality
Open accessAbstract
Background Important improvements have been made in treatment of diseases associated with atrial fibrillation (AF), such as hypertension, myocardial infarction, and heart failure. Incidence rates and risk factors may have changed with the aging of the population and changing lifestyles. Currently, the risk for AF is only partially explained, possibly because of differences between older cohorts and contemporary populations.Objectives This study investigated the incidence of AF in a contemporary cohort in the Netherlands, together with comorbidities associated with AF and associations of AF with cardiovascular outcomes.Methods Incident AF was ascertained for hospital and study electrocardiograms in 8,265 participants of the PREVEND (Prevention of Renal and Vascular End-Stage Disease) study in Groningen, the Netherlands.Results During 9.7 ± 2.3 years of follow-up, 265 participants developed AF, with a resulting overall AF incidence of 3.3 per 1,000 person-years. Advancing age, male sex, antihypertensive drug use, higher body mass index, previous myocardial infarction, and previous stroke were associated with AF. After multivariable adjustment, AF was associated with cardiovascular events (hazard ratio [HR]: 2.24; 95% confidence interval [CI]: 1.06 to 4.75; p = 0.035), heart failure with either reduced or preserved ejection fraction (HR: 4.52; 95% CI: 2.02 to 10.09; p < 0.001), and all-cause mortality (HR: 3.02; 95% CI: 1.73 to 5.27; p < 0.001).Conclusions The incidence of AF in the present cohort was comparable to that shown in data of older studies. Obesity has become a major risk factor for incident AF. Although overall cardiovascular event rates were lower in the present study, the present study confirms the association of incident AF with such events.
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“Obesity 19, 208 none (BMI < 25 kg/m²) overweight (BMI 25-30 kg/m²) obese (BMI ≥ 31 kg/m²) HR: 1.00 (reference) 1.13 (95% CI 0.87-1.46)1.37 (95% CI 1.05-1.78)”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [208]
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Metadata
- Authors
- Vermond, R. A., Geelhoed, B., Verweij, N., Tieleman, R. G., Van der Harst, P., Hillege, H. L., Van Gilst, W. H., Van Gelder, I. C., & Rienstra, M.
- Affiliations
- University Medical Center Groningen (NL)
- Martini Ziekenhuis (NL)
- Corresponding author
- Rienstra, Michiel
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 66
- Issue
- 9
- Pages
- 1000-1007
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1951132801
- Cited by
- 297
- References
- 35
- Citations by year
- 2026: 17 · 2025: 27 · 2024: 38 · 2023: 37 · 2022: 29 · 2021: 24 · 2020: 23 · 2019: 22 · 2018: 21 · 2017: 25 · 2016: 31 · 2015: 3
- FWCI
- 19.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- Bayer
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (016.136.055)
- Medtronic
- Bristol-Myers Squibb
- St. Jude Medical
- Boehringer Ingelheim
- Hartstichting (NHS2010B280)
- Pfizer
- Nierstichting (E0.13)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- atrial fibrillation, incidence, cardiovascular events, heart failure, all-cause mortality, obesity, body mass index, risk factors, antihypertensive drugs, hypertension, myocardial infarction, stroke, PREVEND study, older adults
- MeSH terms
- Adult, Aged, Atrial Fibrillation, Cause of Death, Cross-Sectional Studies, Female, Heart Failure, Humans, Male, Middle Aged, Myocardial Infarction, Netherlands, Retrospective Studies, Cohort Studies, Comorbidity, Incidence, Proportional Hazards Models, Survival Analysis, Age Distribution, Sex Distribution, Risk Assessment, Kaplan-Meier Estimate
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