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. 2022 May 19:41:101055.
doi: 10.1016/j.ijcha.2022.101055. eCollection 2022 Aug.

Age-dependent risk for thromboembolism in atrial fibrillation: The Fushimi AF registry

Masahiro Esato  1 , Yoshimori An  2 , Hisashi Ogawa  2 , Hiromichi Wada  3 , Koji Hasegawa  3 , Hikari Tsuji  4 , Mitsuru Abe  2 , Masaharu Akao  2
Affiliations

Age-dependent risk for thromboembolism in atrial fibrillation: The Fushimi AF registry

Masahiro Esato et al. Int J Cardiol Heart Vasc. .

Abstract

Background: The risk for thromboembolism depending on the different age subgroups in patients with atrial fibrillation (AF) has not been fully elucidated.

Methods: 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).

Results: 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.

Conclusion: The risk and the impact of baseline characteristics on thromboembolism in patients with AF varied depending on the age subgroups.

Keywords: Age subgroups; Atrial fibrillation; Thromboembolism.

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Conflict of interest statement

Dr Akao received lecture fees from Pfizer, Bristol-Myers Squibb, Boehringer Ingelheim, Bayer Healthcare, and Daiichi Sankyo. All other authors have reported that they have no relationships relevant to the content of this paper to disclose.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves and the annual incidence rates for the incidence of thromboembolism. Left; in the entire cohort patients. Right; between the three different age subgroups (≤64, 65–74, and ≥75 years). Comparison data between the age subgroups are presented as HR (95 %CI). HR, hazard ratio; and CI, confidence interval.
Fig. 2
Fig. 2
(A) Variables of determinants-based risk score (full scoring: 0–8) and (B) Kaplan-Meier curves for the incidence of thromboembolism stratified by score assignment (from score 0 group to score ≥ 4 group). BW, body weight; CKD, chronic kidney disease; LA, left atrium; and SE, systemic embolism.
Fig. 3
Fig. 3
Impact of major variables on the incidence of thromboembolism between age subgroups. AF indicates atrial fibrillation; BW, body weight; CI, confidence interval; CKD, chronic kidney disease; HR, hazard ratio; LA, left atrium; and SE, systemic embolism.
See this image and copyright information in PMC

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