Atrial Fibrillation And Heightened Mortality Risk - EMJ

Younger Patients With Atrial Fibrillation Face Heightened Mortality Risk

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A GROUNDBREAKING study conducted at the University of Pittsburgh Medical Center, Pennsylvania, USA, has shed light on the concerning risk factors and outcomes faced by individuals under 65 years old diagnosed with atrial fibrillation (AF). The research, spanning nearly a decade and involving a cohort of over 67,000 patients, reveals a significant burden of comorbidities and heightened mortality rates among this demographic.

The team examined 67,221 adults (mean age: 72.4±12.3 years; 45% female) with AF who were assessed at the University of Pittsburgh Medical Center from January 2010–December 2019. Utilising hospital system electronic health records and administrative data, they identified risk factors, comorbidities, and occurrences of subsequent hospitalisation and cardiac interventions. To analyse the association of AF with all-cause mortality in individuals younger than 65 years, they utilised an internal contemporary cohort of 918,073 patients without AF.

The research found that nearly one-quarter of the studied cohort fell below the age of 65, with a substantial prevalence of cardiovascular risk factors, including smoking, obesity, hypertension, diabetes, heart failure, and coronary artery disease. Over a mean follow-up period exceeding 5 years, more than 6% of patients under 50 years old, and 13% aged 50–65, succumbed to all-cause mortality.

Moreover, younger patients with AF experienced a significantly higher risk of hospitalisation for myocardial infarction, heart failure, and stroke, compared to their older counterparts. Notably, the study revealed that both cardiac and noncardiac risk factors were associated with increased mortality in this population, with heart failure and hypertension demonstrating significant age-related interactions.

These findings underscore the critical importance of tailored management strategies for younger patients with AF, focusing not only on rhythm control but also on mitigating associated comorbidities.



Bhonsale et al. Mortality, hospitalization, and cardiac interventions in patients with atrial fibrillation aged <65 years. Circ Arrhyth Electrophysiol. 2024;17:e012143.


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