Background
Methods
Data source
Study population
Statistical analysis
Results
Characteristics | No. (%) of patients | P-value | ||
---|---|---|---|---|
Overall (n = 5158) | With AF (n = 2091) | Without AF (n = 3067) | ||
Female | 2416 (46.8) | 1025 (49.0) | 1391 (45.4) | 0.010 |
Age, mean (SD), years | 68.4 (14.7) | 70.7 (12.6) | 66.8 (15.7) | < 0.001 |
Age group, years | < 0.001 | |||
< 40 | 271 (5.3) | 46 (2.2) | 225 (7.3) | |
40–49 | 341 (6.6) | 99 (4.7) | 242 (7.9) | |
50–59 | 638 (12.4) | 236 (11.3) | 402 (13.1) | |
60–69 | 1003 (19.4) | 399 (19.1) | 604 (19.7) | |
70–79 | 1744 (33.8) | 799 (38.2) | 945 (30.8) | |
≥ 80 | 1161 (22.5) | 512 (24.5) | 649 (21.2) | |
Height, mean (SD), cm | 159.2 (17.0) | 158.7 (18.7) | 159.5 (15.8) | 0.104 |
Weight, mean (SD), kg | 60.1 (13.7) | 60.0 (13.8) | 60.2 (13.7) | 0.536 |
BMI, mean (SD), kg/m2 | 23.1 (4.4) | 23.1 (4.5) | 23.2 (4.4) | 0.759 |
HF subtypes (n = 4968) | < 0.001 | |||
HFpEF (EF ≥ 50%) | 1260 (25.4) | 656 (32.6) | 604 (20.4) | |
HFmrEF(40% ≤ EF < 50%) | 799 (16.1) | 359 (17.9) | 440 (14.9) | |
HFrEF (EF < 40%) | 2909 (58.6) | 995 (49.5) | 1914 (64.7) | |
Comorbidity at baseline | ||||
Hypertension | 3228 (62.6) | 1302 (62.3) | 1926 (62.8) | 0.699 |
Diabetes mellitus | 2082 (40.4) | 719 (34.4) | 1363 (44.4) | < 0.001 |
Previous stroke | 789 (15.3) | 410 (19.6) | 379 (12.4) | < 0.001 |
Previous chronic renal failure | 732 (14.2) | 259 (12.4) | 473 (15.4) | 0.002 |
IHD | 2237 (43.4) | 627 (30.0) | 1610 (52.5) | < 0.001 |
VHD | 991 (19.2) | 608 (29.1) | 383 (12.5) | < 0.001 |
Cardiomyopathy | 1409 (27.3) | 509 (24.3) | 900 (29.3) | < 0.001 |
COPD | 562 (10.9) | 251 (12.0) | 311 (10.1) | 0.034 |
Medications before discharge | ||||
Angiotensin-converting enzyme inhibitor | 1980 (38.4) | 714 (34.1) | 1266 (41.3) | < 0.001 |
Angiotensin receptor blockers | 2372 (46.0) | 926 (44.3) | 1446 (47.1) | 0.043 |
Βeta-blockers | 3012 (58.4) | 1182 (56.5) | 1830 (59.7) | 0.025 |
Aldosterone antagonist | 2888 (56.0) | 1235 (59.1) | 1653 (53.9) | 0.001 |
Loop diuretics | 4721 (91.5) | 1965 (94.0) | 2756 (89.9) | < 0.001 |
Digoxin | 1708 (33.1) | 1141 (54.6) | 567 (18.5) | < 0.001 |
Warfarin | 1669 (32.4) | 1268 (60.6) | 401 (13.1) | < 0.001 |
Aspirin | 3362 (65.2) | 1194 (57.1) | 2168 (70.7) | < 0.001 |
Statin | 2432 (47.2) | 779 (37.3) | 1653 (53.9) | < 0.001 |
Smoking | < 0.001 | |||
Current smoker | 951 (18.4) | 277 (13.2) | 674 (22.0) | |
Ex-smoker | 1057 (20.5) | 444 (21.2) | 613 (20.0) | |
Never smoker | 3150 (61.1) | 1370 (65.5) | 1780 (58.0) | |
Alcohol intake | 0.288 | |||
Heavy alcoholic | 356 (6.9) | 153 (7.3) | 203 (6.6) | |
Social drinker | 1623 (31.5) | 635 (30.4) | 988 (32.2) | |
Never drinker | 3179 (61.6) | 1303 (62.3) | 1876 (61.2) |
Incidence rates for stroke and all-cause death after 1 and 2 years
Characteristics | At 1 year follow-up | At 2 year follow-up | ||||||
---|---|---|---|---|---|---|---|---|
With AF (n = 2091) | Without AF (n = 3067) | With AF (n = 2091) | Without AF (n = 3067) | |||||
Patients (%) | IR | Patients (%) | IR | Patients (%) | IR | Patients (%) | IR | |
Overall | 94 (4.5) | 5.74 | 86 (2.8) | 3.55 | 116 (5.5) | 3.96 | 103 (3.4) | 2.37 |
Age, years | ||||||||
< 40 | 1 (2.2) | 2.59 | 2 (0.9) | 1.02 | 1 (2.2) | 1.43 | 2 (0.9) | 0.55 |
40–49 | 1 (1.0) | 1.25 | 9 (3.7) | 4.55 | 2 (2.0) | 1.34 | 9 (3.7) | 2.43 |
50–59 | 11 (4.7) | 5.63 | 9 (2.2) | 2.59 | 12 (5.1) | 3.30 | 12 (3.0) | 1.85 |
60–69 | 16 (4.0) | 4.83 | 17 (2.8) | 3.49 | 18 (4.5) | 2.94 | 23 (3.8) | 2.59 |
70–79 | 34 (4.3) | 5.38 | 30 (3.2) | 4.12 | 44 (5.5) | 3.91 | 37 (3.9) | 2.87 |
≥ 80 | 31 (6.1) | 8.62 | 19 (2.9) | 4.10 | 39 (7.6) | 6.43 | 20 (3.1) | 2.56 |
Sex | ||||||||
Male | 41 (3.8) | 4.89 | 55 (3.3) | 4.20 | 52 (4.9) | 3.44 | 65 (3.9) | 2.74 |
Female | 53 (5.2) | 6.63 | 31 (2.2) | 2.79 | 64 (6.2) | 4.53 | 38 (2.7) | 1.93 |
CHA2DS2-VASc score | ||||||||
1 (HF only) | 6 (4.3) | 5.29 | 7 (3.3) | 4.00 | 7 (5.1) | 3.32 | 7 (3.3) | 2.13 |
2 | 9 (3.2) | 3.79 | 4 (0.8) | 0.93 | 9 (3.2) | 2.03 | 5 (1.0) | 0.62 |
3 | 9 (2.6) | 3.19 | 16 (3.3) | 4.04 | 14 (4.1) | 2.69 | 18 (3.7) | 2.47 |
4 | 21 (5.0) | 6.61 | 14 (2.6) | 3.26 | 21 (5.0) | 3.71 | 21 (3.9) | 2.73 |
5 | 18 (4.3) | 5.66 | 17 (2.9) | 3.82 | 22 (5.2) | 3.90 | 20 (3.4) | 2.56 |
6 | 14 (5.1) | 6.91 | 16 (3.8) | 5.04 | 22 (7.9) | 6.36 | 17 (4.0) | 3.07 |
≥ 7 | 17 (7.7) | 10.27 | 12 (3.8) | 5.32 | 21 (9.5) | 7.65 | 15 (4.7) | 3.91 |
Characteristics | At 1 year follow-up | At 2 year follow-up | ||||||
---|---|---|---|---|---|---|---|---|
With AF (n = 2091) | Without AF (n = 3067) | With AF (n = 2091) | Without AF (n = 3067) | |||||
Patients (%) | IR | Patients (%) | IR | Patients (%) | IR | Patients (%) | IR | |
Overall | 446 (21.3) | 26.45 | 643 (21.0) | 26.05 | 626 (29.9) | 20.61 | 905 (29.5) | 20.36 |
Age, years | ||||||||
< 40 | 4 (8.7) | 10.09 | 15 (6.7) | 7.57 | 5 (10.9) | 6.98 | 20 (8.9) | 5.42 |
40–49 | 16 (16.2) | 19.82 | 30 (12.4) | 14.67 | 17 (17.2) | 11.21 | 37 (15.3) | 9.63 |
50–59 | 30 (12.7) | 14.89 | 41 (10.2) | 11.63 | 41 (17.4) | 10.91 | 68 (16.9) | 10.30 |
60–69 | 56 (14.0) | 16.45 | 111 (18.4) | 22.28 | 91 (22.8) | 14.41 | 153 (25.3) | 16.80 |
70–79 | 177 (22.2) | 27.23 | 226 (23.9) | 30.44 | 241 (30.2) | 20.59 | 321 (34.0) | 24.30 |
≥ 80 | 163 (31.8) | 43.59 | 220 (33.9) | 46.52 | 231 (45.1) | 36.28 | 306 (47.1) | 38.31 |
Sex | ||||||||
Male | 230 (21.6) | 26.77 | 354 (21.1) | 26.41 | 316 (29.6) | 20.24 | 500 (29.8) | 20.51 |
Female | 216 (21.1) | 26.11 | 289 (20.8) | 25.61 | 310 (30.2) | 20.99 | 405 (29.1) | 20.19 |
CHA2DS2-VASc score | ||||||||
1 (HF only) | 17 (12.3) | 14.56 | 20 (9.5) | 11.03 | 20 (14.5) | 9.22 | 28 (13.3) | 8.19 |
2 | 32 (11.5) | 13.13 | 59 (11.7) | 13.64 | 45 (16.1) | 9.87 | 82 (16.2) | 10.15 |
3 | 63 (18.5) | 22.09 | 72 (14.8) | 17.60 | 83 (24.3) | 15.68 | 108 (22.1) | 14.35 |
4 | 95 (22.8) | 28.80 | 115 (21.3) | 26.44 | 138 (33.2) | 23.25 | 168 (31.1) | 21.46 |
5 | 92 (21.9) | 28.00 | 148 (25.5) | 32.66 | 135 (32.1) | 22.96 | 209 (36.0) | 26.25 |
6 | 79 (28.5) | 37.57 | 122 (28.8) | 37.53 | 111 (40.1) | 30.65 | 155 (36.6) | 27.32 |
≥ 7 | 68 (30.9) | 39.58 | 107 (33.8) | 45.97 | 94 (42.7) | 32.21 | 155 (48.9) | 39.21 |
Predictive accuracy of CHA2DS2-VASc score
Characteristics | Overall (n = 5158) | With AF (n = 2091) | Without AF (n = 3067) | |||
---|---|---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | |
At 1 year | ||||||
Stroke | ||||||
Model 1 | 1.157 (1.070–1.253) | < 0.001 | 1.165 (1.043–1.302) | 0.007 | 1.145 (1.022–1.282) | 0.019 |
Model 2 | 1.173 (1.072–1.283) | 0.001 | 1.162 (1.028–1.313) | 0.017 | 1.156 (1.006–1.328) | 0.040 |
Model 3 | 1.151 (1.050–1.260) | 0.003 | 1.140 (1.005–1.290) | 0.042 | 1.145 (0.997–1.310) | 0.054 |
C-index (95% CI)a | 0.595 (0.536–0.654) | 0.598 (0.538–0.658) | 0.593 (0.534–0.652) | |||
Death | ||||||
Model 1 | 1.212 (1.174–1.251) | < 0.001 | 1.180 (1.121–1.242) | < 0.001 | 1.233 (1.183–1.284) | < 0.001 |
Model 2 | 1.196 (1.153–1.241) | < 0.001 | 1.165 (1.100–1.234) | < 0.001 | 1.213 (1.155–1.275) | < 0.001 |
C-index (95% CI)a | 0.618 (0.599–0.636) | 0.600 (0.571–0.629) | 0.630 (0.606–0.653) | |||
At 2 year | ||||||
Stroke | ||||||
Model 1 | 1.187 (1.105–1.275) | < 0.001 | 1.212 (1.097–1.340) | < 0.001 | 1.157 (1.044–1.283) | 0.006 |
Model 2 | 1.210 (1.116–1.313) | < 0.001 | 1.237 (1.108–1.381) | < 0.001 | 1.144 (1.009–1.298) | 0.036 |
Model 3 | 1.181 (1.088–1.280) | < 0.001 | 1.204 (1.077–1.350) | 0.001 | 1.128 (0.995–1.280) | 0.061 |
C-index (95% CI)a | 0.626 (0.573–0.680) | 0.639 (0.585–0.694) | 0.613 (0.561–0.666) | |||
Death | ||||||
Model 1 | 1.227 (1.194–1.260) | < 0.001 | 1.207 (1.156–1.260) | < 0.001 | 1.239 (1.197–1.283) | < 0.001 |
Model 2 | 1.210 (1.173–1.248) | < 0.001 | 1.192 (1.135–1.251) | < 0.001 | 1.216 (1.167–1.268) | < 0.001 |
C-index (95% CI)a | 0.635 (0.612–0.658) | 0.626 (0.600–0.652) | 0.635 (0.612–0.658) |