Key result
Advancing age in AF linked to ~51% higher thromboembolism risk per decade.
Why the study?
The risk for thromboembolism across different age subgroups in patients with AF has not been fully elucidated.
Cohort (n=4,440)
Yes
In Japanese patients with atrial fibrillation, the risk of thromboembolism increases with age, and novel risk factors like low body weight, chronic kidney disease, and left atrial enlargement are independent predictors alongside traditional factors.
Age-associated thromboembolism risk in AF merits monitoring; leaves open whether novel factors enhance existing scores.
The risk for thromboembolism depending on the different age subgroups in patients with atrial fibrillation (AF) has not been fully elucidated. The Fushimi AF Registry is a community-based prospective survey of patients with AF in Fushimi-ku, Kyoto. Follow-up data were available for 4,466 patients by the end of 2019. Clinical determinants and the description of variables which interact and lead to the incidence of thromboembolism (the composite of ischemic stroke and systemic embolism [SE]) were identified in overall population and in age subgroups (≤64, 65–74, and ≥ 75 years). A total of 314 patients developed thromboembolism during the median follow-up of 1,610 days (1.56 per 100 person-years). The independent determinants were age advance (per 10 years, hazard ratio [HR]: 1.51, 95% confidence interval [CI]: 1.22–1.86, P < 0.001), low body weight (HR: 1.91, 95% CI: 1.35–2.70, P < 0.001), history of stroke or SE (HR: 2.06, 95% CI: 1.54–2.76, P < 0.001), chronic kidney disease (HR: 1.34, 95% CI: 1.01–1.78, P = 0.043), and left atrial enlargement (HR: 1.57, 95% CI: 1.18–2.10, P = 0.0021). With regard to the age subgroup analysis, diabetes mellitus (P = 0.043), vascular disease (P = 0.005), male sex (P = 0.022), and sustained AF (P = 0.014) indicated significantly relevant interactions between the age subgroups and thromboembolism. The risk and the impact of baseline characteristics on thromboembolism in patients with AF varied depending on the age subgroups.
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Esato et al. (2022) conducted a cohort in Atrial fibrillation (n=4,440). Age advance (per 10 years) was evaluated on Incidence of thromboembolism (composite of ischemic stroke or systemic embolism) (HR 1.51, 95% CI 1.22-1.86, p=<0.001). In patients with atrial fibrillation, advancing age independently increased the risk of thromboembolism by 51% per 10-year increase (HR 1.51).
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