The change in the atrial fibrillation type as a prognosis marker in a community study: Long-term data from AFBAR (Atrial Fibrillation in the BARbanza) study

BackgroundThe aim is to describe the prognosis role of the change in the atrial fibrillation (AF) type in an unselected population of patients with AF currently attending primary care in a single health-service area in Galicia, north-western Spain.MethodsAFBAR is a cohort study that was carried out by 35 primary care providers in 2008. Participants were followed up for a mean of 2.8 ± 0.7 years. 798 patients with the diagnosis of AF who presented at their clinics during a three-month period were recruited. Primary endpoint was mortality or hospital admission.Results778 patients (413 male) were analyzed; mean age 74.8 years old. Hypertension was the most prevalent risk factor (76.5%). Permanent AF was diagnosed in 529 patients (68.0%). Change of AF status occurred in 76 patients (9.8%). During follow-up 52.1% of the patients underwent a primary endpoint and the overall survival was 83.4%. The following independent determinants of primary endpoint were identified: change in AF status (Hazard Ratio (HR) 1.41 (95%-confidence interval (CI) 1.04-1.92); p = 0.026); previous heart failure (HR 1.28 (95%-CI 1.00-1.65); p = 0.050); previous cardiovascular admission (HR 1.54 (95%-CI 1.16-2.03); p = 0.002); stroke (HR 2.02 (95%-CI 1.35-3.03); p = 0.001);ischemic heart disease (HR 1.28 (95%-CI 1.00-1.65); p = 0.050); chronic obstructive pulmonary disease (HR 1.28 (95%-CI 1.00-1.64);p = 0.042); anemia (HR 1.37 (95% CI 1.08-1.75); p = 0.010); or AF-related complications (HR 1.45 (95%-CI 1.18-1.78); p < 0.001).ConclusionsThe change in AF status showed to be an important prognosis marker for death or hospital admissions in a primary care cohort.