In a series of studies, researchers acknowledged that the burden of atrial fibrillation — one of the main atrial fibrillation risk factors for individuals over the age of 65 years — is higher than thought.
In an analysis of 56 cohort studies, they classified as being of the highest to lowest risk of atrial fibrillation based on the patients’ age, sex, body mass index (BMI), educational level and dementia status.
All of the studies provided outcomes for both primary and secondary prevention (PPR), indicating a 12 percent global HR for atrial fibrillation risk to be considered clinically relevant; the highest risk among men was in ICU patients, and the lowest was in the pediatric clinic.
Lead study authors for the instance of the paediatric ICU setting were Dr. Ruslan Kotkin of the Faculty of Health Science and Technology, President of Dalmuir Hospital, and Dr. Dev Charlesy of the University of Oslo and Lund University. They reviewed the published studies to assess whether they might suggest comorbidity, comorbid cardiac diseases, or both, with atrial fibrillation risk.
In general, there was little heterogeneity in terms of demographics or prison setting between studies. For stroke and ischemic heart disease by prison setting, ICU patients had the highest global HR at 19.4 percent (95 percent confidence interval, 5.3 to 22.8 percent). In comparison, dyslipidemia and diabetes at home/guarding, patient populations had a PPR of 6.7 percent (95 percent CI, 2.5 to 10.9 percent) and for hypertension, patients had a PPR of 7.4 percent (95 percent CI, 1.8 to 16.1 percent).The analysis showed that atrial fibrillation disease in ICU patients with comorbidities was relatively similar among those with an event of comorabilit with cardiac disease. Trial participants with comorabilit cardiac disease (P < .001) had the highest risks of atrial fibrillation based on ICU mortality. These findings are added to the high prevalence and severity of the atrial fibrillation risk factors in elderly populations in ICU settings in the context of long hospital stays, increased hospital readmissions and other comorbidities, and acute respiratory distress syndrome as comorbidities. “Our findings laid the foundation for a systematic and interdisciplinary research program based on atrial fibrillation risk factors," the investigators said. “In summary, however, the need for strategies for maintaining these factors within ICU limits their application in the prevention and treatment of atrial fibrillation, which should become a priority for high-risk populations.” Claude J. Hamilton et al. Chronic and acute systems with comorbidities in patients with atrial fibrillation: a retrospective cohort study in the Context of Quality Medicine, Health Policy (2020).