Key result
CHF linked to ~211% greater AF risk in older adults, alongside osteoarthritis and hypertension.
Why the study?
Atrial fibrillation prevalence is growing, particularly in the elderly who face higher risk of life-threatening events, prompting examination of additional risk factors and comorbid conditions in patients aged 65 years or older.
Case-Control (n=2,433)
No
Effect estimate: OR 3.111 (95% CI 1.674 - 5.784)
p-value: p=< 0.001
In elderly patients, increasing age, hypertension, congestive heart failure, osteoarthritis, liver disease, and colorectal disease are significantly associated with increased odds of having atrial fibrillation.
May inform AF risk stratification in older adults with these comorbidities; leaves open causal links and need for prospective validation.
Background: Atrial fibrillation (AF) is the most common arrhythmia with a growing prevalence worldwide, especially in the elderly population. Patients with AF are at higher risk of serious life-threatening events and complications that may lead to long-term sequelae and reduce quality of life. The aim of our study was to examine the association of additional risk factors and comorbid medical conditions with AF in patients 65 years, or older. Methods: We performed a retrospective electronic medical record review of patients aged 65 years and older, who visited our internal medicine office between July 1, 2020 and June 30, 2021. Results: Among 2,433 patients, 418 patients (17.2%) had AF. Our analysis showed that for each unit increased in age, there was a 4.5% increase in the odds of AF (95% confidence interval (CI) 2.2-6.9%; P < 0.001). Compared to patients of Caucasian descent, African-American patients had significantly decreased odds of AF (odds ratio (OR) 0.274, 95% CI 0.141 - 0.531; P < 0.001). Patients with hypertension had 2.241 greater odds of AF (95% CI 1.421 - 3.534; P = 0.001). Additional comorbidities with significantly greater odds of AF included other cardiac arrhythmias (OR 2.523, 95% CI 1.720 - 3.720; P < 0.001), congestive heart failure (OR 3.111, 95% CI 1.674 - 5.784; P < 0.001), osteoarthritis (OR 3.014, 95% CI 2.138 - 4.247; P < 0.001), liver disease (OR 2.129, 95% CI 1.164 - 3.893; P = 0.014), and colorectal disease (OR 1.500 95% CI 1.003 - 2.243; P = 0.048). Comorbidities with significantly decreased odds of AF included other rheumatological disorder (OR 0.144, 95% CI 0.086 - 0.243; P < 0.001), non-steroidal anti-inflammatory drugs (NSAIDs) use (OR 0.206, 95% CI 0.125 - 0.338; P < 0.001), and corticosteroid use (OR 0.553, 95% CI 0.374 - 0.819; P = 0.003). Conclusions: Increasing age, hypertension, presence of other cardiac arrhythmias, congestive heart failure, osteoarthritis, liver disease, and colorectal disease are associated with increased odds of having AF.
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Shin et al. (2023) conducted a case-control in Atrial Fibrillation (n=2,433). Risk factors and comorbidities (e.g., Congestive Heart Failure) vs. Patients without Atrial Fibrillation was evaluated on Odds of Atrial Fibrillation associated with Congestive Heart Failure (OR 3.111, 95% CI 1.674 - 5.784, p=< 0.001). In patients aged 65 years or older, comorbidities including congestive heart failure (OR 3.111), osteoarthritis (OR 3.014), and hypertension (OR 2.241) were significantly associated with increased odds of atrial fibrillation.
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