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Review
. 2024 Feb 1:37:100784.
doi: 10.1016/j.lanepe.2023.100784. eCollection 2024 Feb.

Atrial fibrillation: comorbidities, lifestyle, and patient factors

Eduard Shantsila  1   2   3 , Eue-Keun Choi  4 , Deirdre A Lane  2   5   6 , Boyoung Joung  7 , Gregory Y H Lip  2   5   6
Affiliations
Review

Atrial fibrillation: comorbidities, lifestyle, and patient factors

Eduard Shantsila et al. Lancet Reg Health Eur. .

Abstract

Modern anticoagulation therapy has dramatically reduced the risk of stroke and systemic thromboembolism in people with atrial fibrillation (AF). However, AF still impairs quality of life, increases the risk of stroke and heart failure, and is linked to cognitive impairment. There is also a recognition of the residual risk of thromboembolic complications despite anticoagulation. Hence, AF management is evolving towards a more comprehensive understanding of risk factors predisposing to the development of this arrhythmia, its' complications and interventions to mitigate the risk. This review summarises the recent advances in understanding of risk factors for incident AF and managing these risk factors. It includes a discussion of lifestyle, somatic, psychological, and socioeconomic risk factors. The available data call for a practice shift towards a more individualised approach considering an increasingly broader range of health and patient factors contributing to AF-related health burden. The review highlights the needs of people living with co-morbidities (especially with multimorbidity), polypharmacy and the role of the changing population demographics affecting the European region and globally.

Keywords: Atrial fibrillation; Comorbidities; Lifestyle; Risk factors.

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Conflict of interest statement

ES: none; EKC: Research grants or speaking fees from Abbott, Bayer, BMS/Pfizer, Biosense Webster, Chong Kun Dang, Daewoong Pharmaceutical Co., Daiichi-Sankyo, DeepQure, Dreamtech Co., Ltd., Jeil Pharmaceutical Co. Ltd., Medtronic, Samjinpharm, Seers Technology, and Skylabs; DAL: DAL has received investigator-initiated educational grants from Bristol Myers Squibb (BMS) and Pfizer; been a speaker for Boehringer Ingelheim, BMS/Pfizer and Bayer, and consulted for Boehringer Ingelheim and BMS/Pfizer; all outside the submitted work. DAL is also a co-applicant on EU Commission funded projects on atrial fibrillation; BJ: none; GYL: reports consultancy and speaker fees from BMS/Pfizer, Boehringer Ingelheim and Daiichi-Sankyo outside the submitted work. No fees received personally.

Figures

Fig. 1
Fig. 1
Factors associated with incident atrial fibrillation.
Fig. 2
Fig. 2
Mechanisms linking obesity and risk of atrial fibrillation.
Fig. 3
Fig. 3
Ethnicity and risk of atrial fibrillation.
See this image and copyright information in PMC

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