Title

Risk Factors associated with atrial fibrillation

Authors

Jeeyong Shin, Samuel Snyder, Jesse Viggiano, Matthew Stern, Logan Napoli, Lindsey DeJean, Gabriella Yao, Cynthia Nguyen, Alyssa Exarchakis, Roshni Gandhi, Reshma Paul, Joseph Sichel, Megha Andrews, Christina Hum, Abyson Kalladanthyil, Nicole Debski, Nicole Schmalbach, Subhadra Thampi, Rohini Maddigunta, Julia Fleming, Krystal Hunter, Satyajeet Roy

Introduction

Atrial fibrillation (AF) is the most common arrythmia with a growing prevalence worldwide, especially in the elderly population. Patients with AF are at higher risk of serious life-threatening and complications that may lead to long-term sequelae and reduce quality of life. The aim of our study was to examine the association of risk factors and comorbid medical conditions with AF in patients 65 years, or older.

Methods

We performed a retrospective electronic medical record review of patients aged 65 years and older, who visited our internal medicine office between July 1, 2020 and June 30, 2021. For statistical analysis, patients were divided into two groups: patients who had AF and patients who did not have AF. Univariate analysis was performed with independent t-test, Mann Whitney U-test, and Chi Square test. Multivariate analysis was performed by using tree analysis to get a listing of important factors in AF, which were used as independent variables and entered in the logistic regression, with AF as the dependent variable.

Results

Among 2433 patients, 418 patients (17.2%) had AF. We found that for each unit increased in age, there was a 4.5% increase in the odds of AF (95% confidence interval (CI) 2.2% – 6.9%; P < 0.001). Compared to patients of White race, Black patients had significantly decreased odds of AF with an odds ratio of 0.274 (95% CI 0.141 – 0.531; P < 0.001). Patients with hypertension had 2.241 greater odds of AF (95% CI 1.421 – 3.534; P = 0.001). Additional comorbidities with significantly greater odds of AF included other cardiac arrythmias (OR 2.523, 95% CI 1.720 – 3.720; P < 0.001), congestive heart failure (OR 3.111, 95% CI 1.674 – 5.784; P < 0.001), osteoarthritis (OR 3.014, 95% CI 2.138 – 4.247; P < 0.001), liver disease (OR 2.129, 95% CI 1.164 – 3.893; P = 0.014), and colorectal disease (OR 1.500, 95% CI 1..003 – 2.243; P = 0.048). Comorbidities with significantly decreased odds of AF included other rheumatologic disorder (OR 0.144, 95% CI 0.086 – 0.243; P < 0.001), NSAIDs use (OR 0.206, 95% CI 0.125 – 0.338; P < 0.001), and corticosteroid use (OR 0.553, 95% CI 0.374 – 0.819; P = 0.003).

Conclusion

Advancing age, White race, hypertension, presence of other cardiac arrythmias, congestive heart failure, osteoarthritis, liver disease, and colorectal disease, are associated with greater odds of AF. When assessing the elderly patients, identification of these risk factors along with established risk factors, may assist clinicians to have a high index of suspicion for AF to formulate appropriate therapeutic plans.

References

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