Atrial Fibrillation May be More Common in Younger Adults than Previously Thought: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in Circulation Arrhythmia and Electrophysiology that examined the risk factor (RF) burden, clinical course, and long-term outcomes among patients aged less than 65 years with atrial fibrillation (AF).

The study

The study included patients aged 18 years and older who had at least 2 outpatient visits at the University of Pittsburgh Medical Center with an associated diagnosis of AF. Participants were evaluated between January 4, 2010, and December 31, 2019. The primary outcome was all-cause mortality and secondary outcomes included hospitalization for cardiovascular causes, myocardial infarction (MI), AF, heart failure (HF), stroke, or major bleeding.

The findings

Based on electronic health records for a total of 67 221 patients who sought care for AF (mean age, 72.4 years; 45% women; 95% White), more than one-quarter (26%, n=17 335) were aged less than 65 years at initial evaluation (32% women) and included in the researchers’ analysis.

Cardiovascular RF burden was considerable among patients aged less than 65 years. More than 20% of individuals had significant obesity, 16% were current smokers, 55% had HTN, 21% had diabetes, 20% had HF, 19% had coronary artery disease, and 6% had prior ischemic stroke. Also, more than half (55%) were receiving anticoagulants.

Over a mean follow-up of more than 5 years, 6.7% (n=204) of patients aged less than 50 years and 13.1% (n=1880) of patients aged 50-65 years died. The proportion of patients with more than 1 hospitalization for HF, MI, and stroke was 1.3%, 4.8%, and 1.1% for those aged less than 50 years and 2.2%, 7.4%, and 1.1% for those aged 50-65 years, respectively.

Authors' comment

"The results of our study suggest that management of patients with atrial fibrillation aged <65 years must be in the context of their individual cardiovascular risk factors burden and lifestyle modification with an appropriate focus on noncardiac risk factors."

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