New-Onset Atrial Fibrillation Tied to Increased Mortality

Risk of mortality, cardiovascular events higher in women with new-onset atrial fibrillation

TUESDAY, May 24 (HealthDay News) -- Women with new-onset atrial fibrillation (AF) may have an increased risk of all-cause, cardiovascular, and noncardiovascular mortality, according to a study published May 25 in the Journal of the American Medical Association.

David Conen, M.D., M.P.H., from University Hospital in Basel, Switzerland, and colleagues assessed the association of new-onset AF with mortality and other cardiovascular comorbidities in initially healthy women. The participants, which included 34,722 women aged over 45 years, were free from AF and other cardiovascular diseases at baseline and were followed up for a median of 15.4 years. Women with paroxysmal AF were included in secondary analyses. All-cause, cardiovascular, and noncardiovascular mortality were the primary outcomes, and stroke, congestive heart failure, and myocardial infarction were the secondary outcomes.

The investigators found that AF developed in 1,011 participants. Women with AF had a significantly higher incident rate for all-cause, cardiovascular, and noncardiovascular mortality compared to women without AF. Women with new-onset AF had significantly increased hazard ratios for all-cause, cardiovascular, and noncardiovascular mortality, after adjusting for confounders (hazard ratio [HR], 2.14, 4.18, and 1.66, respectively). After adjusting for nonfatal cardiovascular events potentially related to death, these risks were attenuated, but the association still remained (HR, all-cause mortality, 1.70; cardiovascular, 2.57; and noncardiovascular, 1.42, respectively). Women with paroxysmal AF had an increased risk only of cardiovascular mortality (HR, 2.94).

"Women with new-onset AF had an increased risk of death and incident cardiovascular events," the authors write. "A significant proportion of the excess mortality risk appears attributable to the occurrence of nonfatal cardiovascular events prior to death."

Several of the study authors disclosed financial ties to the pharmaceutical, medical device, and biotechnology industries.

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