ASSOCIATIONS OF RISK FACTORS AND OUTCOMES IN PATIENTS WITH NEWLY DIAGNOSED ATRIAL FIBRILLATION

Highlights

The results obtained in the study will make it possible to introduce the use of markers of myocardial fibrosis in real practice in order to diagnose the degree of fibrosis during a newly reported episode of atrial fibrillation, and subsequently predict the possibility of restoring rhythm and developing recurrent arrhythmia, and stratify the risks of complications.

Abstract

Aim. To determine the significance of risk factors and concomitant pathology in patients with newly diagnosed atrial fibrillation and their impact on significant clinical outcomes.

Methods. The study included 143 patients, including 50 patients without severe chronic noncommunicable diseases who meet the inclusion criteria (absence of severe cardiovascular diseases, absence of diseases accompanied by severe fibrosis, absence of a pacemaker, absence of hemodynamically significant heart defects that can lead to surgical treatment within a year, absence of chronic heart failure and survival > 2 years). Patients' complaints were studied, medical history, as well as laboratory tests of markers of myocardial fibrosis (transforming growth factor β, galectin 3), as well as instrumental research methods (electrocardiography, echocardiography). The assessment of adverse clinical outcomes was carried out within 1 year after inclusion in the study.

Results. Thyroid diseases (RR 1.516 95% CI [1.235; 1.862]), obesity (RR 2.571 95% CI [1.241; 5.327]), hypertension (RR 3.214 95% CI [1.374; 7.521]), hemodynamically significant heart defects (RR 1.469 95% CI [1.208; 1.786]) are clinically significant risk factors for the development of adverse clinical outcomes (myocardial infarction, stroke, repeated hospitalization, coronary angiography, radiofrequency ablation) with newly diagnosed atrial fibrillation. A high level of transformative growth factor β increases the chances of adverse outcomes by 7.66 times (95% CI: 2.32–25.35) and the chances of repeated hospitalization by 31.4 times (95% CI: 2.48–397.39). Galectin 3 had no significant impact on the risk of repeated hospitalization and the development of adverse clinical outcomes. Risk of adverse clinical outcomes was high in case of transformative growth factor β level equal to or greater than 5.61 ng/mL.

Conclusion. Transforming growth factor β is a promising marker for predicting the risk of repeated hospitalization, as well as a marker for the development of adverse clinical outcomes such as myocardial infarction, stroke, repeated hospitalization, radiofrequency ablation and coronary angiography. Thyroid diseases, obesity, arterial hypertension, and heart defects are clinically significant risk factors for the development of adverse clinical outcomes in newly diagnosed atrial fibrillation.

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