Characterizing patients with newly diagnosed atrial fibrillation compared to those with established atrial fibrillation: data from the CODE-AF registry. (4th February 2022)

• Record Type: Journal Article
• Authors: Choi, J M; Lee, S R; Choi, E K
• Is Part Of: European heart journal. Volume 43(2022)Supplement 1
• Publication Date: 2022-02-04
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab849.025
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: Foundation. Main funding source(s): Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare OnBehalf: CODE-AF investigator Background/Introduction: The characteristic of atrial fibrillation (AF), such as the risk of complications, may differ depending on the time after diagnosis. Purpose: This study aimed to compare the baseline characteristics according to the AF diagnosis duration using a large multicenter prospective registry: CODE-AF (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation). Methods: A total of 10, 021 patients with AF were enrolled between May 2016 to March 2021. We defined patients into two groups: the newly diagnosed (AF duration less than 3 months before enrollment) and the established (AF duration more than 3 months before enrollment) AF groups. We compared the baseline characteristics and the incidence of the composite outcomes (stroke, all-bleeding, heart failure and all-cause death) during follow-up period between the two groups. The survival analysis was performed using Kaplan-Meier curve analysis with validation by log-rank test. Results: Among the 10, 021 patients with AF (age 67.0 ±14.5 years, female 35.7%), patients with newly diagnosed AF were 2181, and those with established AF were 7840. Two groups did not differ between sex, weight, height, and body mass index. The newly diagnosed AF group was younger with higher tobacco and alcohol consumption compared to the established AF group. The established AF group had more comorbidities at the time of enrollment. Also, CHA2DS2-VASc score (2.36 ±1.64 vs. 2.68 ±1.67, p <0.001) and HAS-BLED score (1.55 ±1.02vs. 1.86 ±1.06 p <0.001) were both higher in established AF. The newly diagnosed AF group had a lower proportion of oral anticoagulation prescription (68.6% vs. 73.0%, p <0.001), whereas prescription of non-vitamin K antagonist oral anticoagulants was higher compared to those with established AF (75.7% vs. 68.9%, p <0.001) (Table). There was no significant difference in the event-free survival during the overall follow-up period on the composite outcomes. However, the newly diagnosed AF group showed a significantly higher risk of the composite outcomes within 90 days of enrollment than the established AF group (hazard ratio 2.01, 95% confidence interval 1.48 to 2.72) (Figure). Conclusion: The newly diagnosed AF group showed different characteristics compared to the established AF group. Also, the composite clinical outcomes, including stroke, bleeding, heart failure, and all-cause death, had occurred more frequently during the early period after diagnosis in the newly diagnosed AF group. For the better clinical outcome of patients with newly diagnosed AF, structured assessment and comprehensive management is needed, especially during the early period after diagnosis.