Incidence and Risk Assessment for Atrial Fibrillation at 5 Years: Hypertensive Diabetic Retrospective Cohort

Eulalia Muria-Subirats, Josep Lluis Clua-Espuny, Juan Ballesta-Ors, Blanca Lorman-Carbo, Iñigo Lechuga-Duran, Jose Fernández-Saez, Roger Pla-Farnos, On Behalf Members Of Africat Group, Eulalia Muria-Subirats, Josep Lluis Clua-Espuny, Juan Ballesta-Ors, Blanca Lorman-Carbo, Iñigo Lechuga-Duran, Jose Fernández-Saez, Roger Pla-Farnos, On Behalf Members Of Africat Group

Abstract

(1) Background: The link between diabetes and hypertension is mutual and reciprocal, increasing the risks for the development of atrial fibrillation (AF). The main objective was to develop a prediction model for AF in a population with both diabetes and hypertension at five years of follow-up. (2) Methods: A multicenter and community-based cohort study was undertaken of 8237 hypertensive diabetic patients without AF between 1 January 2103 and 31 December 2017. Multivariate Cox proportional-hazards regression models were used to identify predictors AF and to stratify risk scores by quartiles. (3) Results: AF incidence was 10.5/1000 people/years (95% confidence interval (CI) 9.5-11.5), higher in men. The independent prognostic factors identified: age (hazard ratio (HR) 1.07 95% CI 1.05-1.09, p < 0.001), weight (HR 1.03 95% CI 1.02-1.04, p < 0.001), CHA2DS2VASc score (HR 1.57 95% CI 1.16-2.13, p = 0.003) and female gender (HR 0.55 95% CI 0.37-0.82, p = 0.004). Q4 (highest-risk group for AF) had the highest AF incidence, stroke and mortality, and the smallest number needed to screen to detect one case of AF. (4) Conclusions: Risk-based screening for AF should be used in high cardiovascular risk patients as the hypertensive diabetics, for treatment of modifiable cardiovascular risk, and monitoring AF detection.

Keywords: Atrial Fibrillation; Chronic diseases; Cohort study; Stroke; diabetes; hypertensive; risk assessment.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Function for predicting AF risk at 5 years.

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