Prognosis of Atrial Fibrillation with or without Comorbidities: Analysis of Younger Adults from a Nationwide Database

Objective: To assess the prognosis of AF patients with or without cardiac or extra-cardiac concomitant conditions. Participants and Methods: All consecutive patients diagnosed with AF admitted to French hospitals between 2011 and 2020 were identified. Patients were classified into four groups: (1) > 60 yo; (2) with known cardiac disease (KCD group); (3) with extra-cardiac comorbidities (ECC); and 4) AF without KCD or ECC (Lone AF). Results: Altogether 2,435,541 patients were identified, from which 2,203,702 patients aged >60 years and 231,839 patients aged <60 years (with KCD (55.2%), with ECC (14.7%) and with Lone AF (30.1%)). During follow-up, the incidences of all-cause and CV deaths were 13.7%, 5.7%, 6.2%, and 2.3%, and 4.2%, 1.7%, 0.8%, and 0.3% in the older than 60 yo group, KCD group, ECC group and Lone AF AF group, respectively. In the age and sex-adjusted analysis (patients < 60 yo), patients with AF and KCD had worse outcomes than patients with Lone AF for all major cardiac events. Conclusion: There are three distinct prognostic criteria based on the presence or lack of HD or extra-cardiac concomitant comorbidities. Patients in the so-called Lone AF group remain severe in terms of CV events but still with a lower incidence than the patients with associated KCD or ECC. The presence of KCD or ECC makes it possible to distinguish a profile in terms of events that are very different between the patients.

Automated summary

The study aims to assess the prognosis of AF patients and found that patients with cardiac or extra-cardiac concomitant conditions have worse outcomes compared to patients with Lone AF.