Comparison of risk profiles for new-onset atrial fibrillation between patients aged <60 and ≥60 years

• Published in: PloS one Vol. 16; no. 11; p. e0258770
• Main Authors: Kim, In-Soo, Choi, Yeon-Jik, Choi, Eui-Young, Min, Pil-Ki, Yoon, Young Won, Lee, Byoung Kwon, Hong, Bum-Kee, Rim, Se-Joong, Kwon, Hyuck Moon, Kim, Jong-Youn
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18-11-2021; Public Library of Science (PLoS)
• Subjects: Adult; Age; Age Factors; Age of Onset; Aged; Aging; Alcohol use; Atrial fibrillation; Atrial Fibrillation - complications; Atrial Fibrillation - epidemiology; Atrial Fibrillation - physiopathology; Biology and Life Sciences; Body mass; Body Mass Index; Body size; Cardiac arrhythmia; Cardiology; Cardiovascular diseases; Care and treatment; Chronic obstructive pulmonary disease; Congestive heart failure; Coronary artery disease; Diabetes; Exercise; Failure analysis; Female; Fibrillation; Health aspects; Health insurance; Health risks; Heart diseases; Heart failure; Heart Failure - complications; Heart Failure - epidemiology; Heart Failure - physiopathology; Hospitals; Humans; Hypertension; Hypertension - complications; Hypertension - epidemiology; Hypertension - physiopathology; Ischemia; Kidney diseases; Lung diseases; Male; Medical schools; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Obesity; Obesity - complications; Obesity - epidemiology; Obesity - physiopathology; Obstructive lung disease; Patients; Population; Prostheses; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Regression analysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - physiopathology; Republic of Korea - epidemiology; Risk analysis; Risk assessment; Risk Factors; Stroke - complications; Stroke - epidemiology; Stroke - physiopathology; Transient ischemic attack; Republic of Korea; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0258770

Atrial fibrillation (AF) has a heterogeneous pathophysiology according to individual patient characteristics. This study aimed to identify the effects of widely known risk factors on AF incidence according to age and to elucidate the clinical implications of these effects.
We analyzed data from 501,668 subjects (≥18years old) without AF and valvular heart disease from the Korean National Health Insurance Service-National Sample Cohort. The total population was divided into two groups according to age, <60years and ≥60years. AF occurred in 0.7% of the overall population (3,416 of 501,668) during the follow-up period (mean 47.6 months). In Cox regression analysis, age, male sex, previous ischemic stroke, heart failure, and hypertension were related to increased risk of new-onset AF in both age groups. Especially in the <60years age group, risk of new-onset AF was increased by relatively modifiable risk factors: obesity (body mass index ≥25kg/m2; hazard ratio[HR] 1.37 [1.22-1.55], p<0.001, interaction p<0.001), and hypertension (HR 1.93[1.69-2.22], p<0.001, interaction p<0.001). Although interactions were not significant, chronic obstructive pulmonary disease (HR 1.41[1.24-1.60], p<0.001) and chronic kidney disease (HR 1.28[1.15-1.41], p<0.001) showed increased trends of the risk of new-onset AF in the ≥60years age group.
The risk profile for new-onset AF was somewhat different between the <60years and the ≥60years age groups. Compared to the ≥60years group, relatively modifiable risk factors (such as obesity and hypertension) had a greater impact on AF incidence in the <60years age group. Different management strategies to prevent AF development according to age may be needed.