Key result
Higher predicted AF risk is linked to ~10-fold greater risk of cardio-renal-metabolic disease and death.
Why the study?
Risk-guided atrial fibrillation screening may prevent adverse events beyond stroke, but the associated risk of new cardio-renal-metabolic diseases and death is unclear.
Are individuals identified at higher-predicted AF risk using the FIND-AF score at increased risk for incident cardio-renal-metabolic diseases and death compared to those at lower risk?
Cohort (n=416,228)
Yes
Are individuals identified at higher-predicted AF risk using the FIND-AF score at increased risk for incident cardio-renal-metabolic diseases and death compared to those at lower risk?
Hazard Ratio: 10.45 (95% CI 10.23–10.68)
Individuals identified as high risk for AF by the FIND-AF score are also at substantially elevated risk for a broad spectrum of cardio-renal-metabolic diseases and death, suggesting they may benefit from holistic preventive interventions beyond just ECG monitoring.
High FIND-AF risk may support broader cardio-renal-metabolic assessment; leaves open whether preventive interventions improve outcomes.
OBJECTIVE: Risk-guided atrial fibrillation (AF) screening may be an opportunity to prevent adverse events in addition to stroke. We compared events rates for new diagnoses of cardio-renal-metabolic diseases and death in individuals identified at higher versus lower-predicted AF risk. METHODS: From the UK Clinical Practice Research Datalink-GOLD dataset, 2 January 1998-30 November 2018, we identified individuals aged ≥30 years without known AF. The risk of AF was estimated using the FIND-AF (Future Innovations in Novel Detection of Atrial Fibrillation) risk score. We calculated cumulative incidence rates and fit Fine and Gray's models at 1, 5 and 10 years for nine diseases and death adjusting for competing risks. RESULTS: Of 416 228 individuals in the cohort, 82 942 were identified as higher risk for AF. Higher-predicted risk, compared with lower-predicted risk, was associated with incident chronic kidney disease (cumulative incidence per 1000 persons at 10 years 245.2; HR 6.85, 95% CI 6.70 to 7.00; median time to event 5.44 years), heart failure (124.7; 12.54, 12.08 to 13.01; 4.06), diabetes mellitus (123.3; 2.05, 2.00 to 2.10; 3.45), stroke/transient ischaemic attack (118.9; 8.07, 7.80 to 8.34; 4.27), myocardial infarction (69.6; 5.02, 4.82 to 5.22; 4.32), peripheral vascular disease (44.6; 6.62, 6.28 to 6.98; 4.28), valvular heart disease (37.8; 6.49, 6.14 to 6.85; 4.54), aortic stenosis (18.7; 9.98, 9.16 to 10.87; 4.41) and death from any cause (273.9; 10.45, 10.23 to 10.68; 4.75). The higher-risk group constituted 74% of deaths from cardiovascular or cerebrovascular causes (8582 of 11 676). CONCLUSIONS: Individuals identified for risk-guided AF screening are at risk of new diseases across the cardio-renal-metabolic spectrum and death, and may benefit from interventions beyond ECG monitoring.
No takes yet. Share an insight, caveat, or question.
Wu et al. (2023) conducted a cohort in Without known atrial fibrillation (n=416,228). Higher-predicted AF risk (FIND-AF risk score) vs. Lower-predicted AF risk was evaluated on Death from any cause (HR 10.45, 95% CI 10.23 to 10.68). Higher-predicted AF risk was associated with significantly increased risks of incident cardio-renal-metabolic diseases and death from any cause (HR 10.45; 95% CI 10.23-10.68) compared to lower risk.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: