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European Society of Hypertension, Dr Paolo Verdecchia

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“HIGH-RISK” VASCULAR PATIENTS VULNERABLE TO AF

High-risk vascular patients are considerably more vulnerable to new-onset atrial fibrillation (AF) than the general population, according to an evaluation of the ONTARGET and TRANSCEND studies by Dr Paolo Verdecchia (Ospedale di Assisi, Italy), presented at the European Society of Hypertension (ESH) 2011 European Meeting on Hypertension.

Researchers led by Verdecchia analysed the ONTARGET/TRANSCEND data from 30,424 patients with coronary artery disease, cerebrovascular disease, peripheral arterial disease, or complicated diabetes.  Those with AF at baseline were excluded, along with those whose AF or blood pressure (BP) at baseline were not recorded.

Verdecchia and colleagues examined the patients’ ECGs at two-year follow up, dividing the patients into those with new-onset AF (n = 1,000 approx.), and those classified as remaining in sinus rhythm. The researchers were not able to distinguish between paroxysmal, sustained, and chronic AF.

Over the 4.7 years of follow-up, rates of new-onset AF were 1.5 per 100 patients per year, differing according to age, with a rate of 1% per year in those under 60 years of age and 2% per year in those over 60.  Researchers also identified hip circumference as a novel determinant of AF – a stronger predictor of obesity than waist circumference – speculating that the cardiostimulant hormone leptin may explain its contribution.

“In a very short period of time, just a few years, new-onset AF was associated with a significantly higher risk of cardiovascular mortality and congestive heart failure,” said Verdecchia.

Unexpectedly, however, the risk of MI decreased in patients with new-onset AF, perhaps because of the greater use of anticoagulants such as warfarin, he observed. 48.7% of those with new-onset AF were taking vitamin-K antagonists, compared with 5.2% of patients who remained in sinus rhythm.

Published on: August 2, 2011

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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