Atrial fibrillation was associated with a 32% increased risk of mortality (HR 1.32; 95% CI 1.19-1.46), with higher risk among those with ECG-detected AF and those unaware of their diagnosis.
Cohort (n=25,976)
Yes
Does asymptomatic, nonhospitalized atrial fibrillation increase the risk of mortality in the general population?
Asymptomatic, nonhospitalized atrial fibrillation, particularly when patients are unaware of the diagnosis, is associated with a significantly increased risk of mortality.
Hazard Ratio: 1.32 (95% CI 1.19–1.46)
BACKGROUND: Although mortality associated with atrial fibrillation (AF) has been reported to decrease over prior decades, the mortality risk of asymptomatic, nonhospitalized AF has not been examined. HYPOTHESIS: Asymptomatic, nonhospitalized AF is associated with an increased risk of death. METHODS: This analysis included 25,976 participants (mean age, 65 ± 9.4 years; 55% female; 38% black) from the Reasons for Geographic And Racial Differences (REGARDS) study. Atrial fibrillation was detected on the baseline electrocardiogram (ECG AF) or by self-reported history. Atrial fibrillation unawareness was defined as present if ECG evidence of the arrhythmia was detected but no self-reported history was reported. All-cause mortality was confirmed during follow-up through March 31, 2014. RESULTS: A total of 2208 (8.5%) participants had AF at baseline (ECG: n = 371/17%; self-reported: n = 1837/83%). Over a median follow-up of 7.6 years, 3481 deaths occurred. In a multivariable Cox regression model, AF was associated with a 32% increased risk of mortality (95% confidence interval CI: 1.19-1.46). Risk of death was higher among those with ECG AF (hazard ratio: 1.71, 95% CI: 1.42-2.07) compared with self-reported cases (hazard ratio: 1.15, 95% CI: 1.03-1.29). Those who were unaware of their AF diagnosis had a 94% increased risk of death (95% CI: 1.50-2.52) compared with AF participants who were aware of their diagnosis. CONCLUSIONS: Asymptomatic, nonhospitalized AF is associated with an increased risk of mortality in the general population. Mortality is higher in those with ECG-confirmed cases and among those who are unaware of their diagnosis.
O’Neal et al. (2016) conducted a cohort in Atrial fibrillation (n=25,976). Atrial fibrillation vs. No atrial fibrillation was evaluated on All-cause mortality (HR 1.32, 95% CI 1.19-1.46). Atrial fibrillation was associated with a 32% increased risk of mortality (HR 1.32; 95% CI 1.19-1.46), with higher risk among those with ECG-detected AF and those unaware of their diagnosis.