Key result
Mitral stenosis-related AF carries similar 1-year mortality and stroke risk compared to NVAF.
Why the study?
Mitral stenosis is common in developing countries and poses an AF risk; this study sought to delineate clinical characteristics, adverse outcomes, and healthcare utilization in recent NVAF versus AF related to mitral stenosis.
Does atrial fibrillation related to mitral stenosis have different clinical outcomes compared to non-valvular atrial fibrillation in patients with recent-onset AF?
Cohort (n=84)
No
Does atrial fibrillation related to mitral stenosis have different clinical outcomes compared to non-valvular atrial fibrillation in patients with recent-onset AF?
Despite being significantly younger and having fewer cardiovascular risk factors, patients with atrial fibrillation related to mitral stenosis experience comparable rates of mortality, stroke, and hospitalization to those with non-valvular atrial fibrillation.
Comparable short-term risks in mitral stenosis AF; leaves open whether anticoagulation should differ from non-valvular AF.
Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and is associated with significant morbidity and mortality. Mitral stenosis (MS) is common in developing countries, affecting the younger population and posing a risk of atrial fibrillation. Objectives: This study aims to delineate the clinical characteristics and poor outcomes in patients who have recent non-valvular AF (NVAF) compared with AF related to MS (MS-AF). Furthermore, it seeks to assess the healthcare resource utilization associated with the management of AF patients in the two groups. Patients and methods: This is a prospective observational cohort conducted on 84 patients with recent AF. The patients were divided into two groups: the NVAF group (patients with no prosthetic valves or moderate/severe MS) and the MS-AF group (patients with AF in the presence of moderate/severe MS). The clinical characteristics, stroke risk, and anticoagulation regimens were assessed. AF-related outcomes (strokes, hospitalizations, major bleeding, and mortalities) were monitored and compared between the two groups. Results: The mean age of the studied AF patients was 49.80 ± 16.31 years, ranging from 25 to 89 years. Patients with MS-AF were significantly younger than patients with NVAF. Hypertension was the most prevalent risk factor associated with AF. Smoking, heart failure, and hypertension were more prevalent among patients with NVAF. The NVAF group received less anticoagulants than the MS-AF group. There were no statistically significant differences between the two groups regarding the overall incidence of death, stroke, myocardial infarction, TIA, or hospital admissions. In the overall studied group, all-cause mortality was higher among AF patients with a history of heart failure or stroke. Conclusion: Patients with NVAF had a significantly greater incidence of cardiovascular disease risk factors. However, AF related to mitral stenosis was associated with comparable worse outcomes.
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Aboelhassan et al. (2025) conducted a cohort in Recent-onset atrial fibrillation (n=84). Atrial fibrillation with moderate-to-severe mitral stenosis vs. Non-valvular atrial fibrillation was evaluated on All-cause mortality (p=0.746). Atrial fibrillation related to mitral stenosis was associated with comparable 1-year rates of all-cause mortality (11.9% vs 14.3%) and stroke compared to non-valvular atrial fibrillation.
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