Marfan syndrome patients with atrial fibrillation/flutter had a 4.04-fold higher risk of aortic dissection and a 4.23-fold higher mortality hazard than those without.
Does the presence of atrial fibrillation or atrial flutter increase the risk of aortic dissection and mortality in patients with Marfan syndrome?
In patients with Marfan syndrome, the presence of atrial fibrillation or flutter is associated with a four-fold increased risk of aortic dissection and mortality.
Absolute Event Rate: 0% vs 0%
Abstract Background Marfan syndrome (MFS) predisposes individuals to aortic dissections. Recent data suggest that atrial fibrillation and atrial flutter (AF/AFL) may increase complications and mortality in MFS patients; however, their independent role in aortic dissection remains unclear. Purpose This study aims to assess the risk of aortic dissection in MFS patients with and without AF/AFL. Methods Using the TriNetX database and ICD-10 codes, 2,447 MFS patients with AF/AFL and 20,520 without were identified. Demographics (age, sex, race, ethnicity) were evaluated, and aortic dissection outcomes were compared using risk ratios and Kaplan-Meier survival analysis. Results Patients in the AF/AFL cohort were older (mean age 60.9 ± 16.7 years vs. 38 ± 16.6 years) and had higher proportions of males (62.51% vs. 56.76%) and white patients (74.67% vs. 66.3%). Aortic dissections occurred in 13.9% of MFS patients with AF/AFL compared to 3.4% of those without, resulting in a risk difference of 10.5% (95% CI: 9.0%–11.9%) and a risk ratio of 4.04 (95% CI: 3.547–4.603). Kaplan-Meier analysis revealed significantly lower survival rates in the AF/AFL cohort (74.07% vs. 90.63%; log-rank test, p 0.0001), with a hazard ratio of 4.232 (95% CI: 3.686–4.858). Conclusion In MFS patients, those with AF/AFL were over four times more likely to experience aortic dissection and had over four times the hazard of mortality. Screening and managing AF/AFL may be essential to preventing aortic dissections and improving outcomes in this population.Figure 1
Kanaan et al. (Sat,) reported a other. Marfan syndrome patients with atrial fibrillation/flutter had a 4.04-fold higher risk of aortic dissection and a 4.23-fold higher mortality hazard than those without.