Cardiovascular and Renal Multimorbidity Increase Risk of Atrial Fibrillation in the PREVEND Cohort

Overview

Journal Open Heart

Publisher BMJ Publishing Group

Specialty Cardiology & Vascular Diseases

Date 2023 Jul 17

PMID 37460268

Authors

Colinda van Deutekom

Bastiaan Geelhoed

Barbara C van Munster

Stephan J L Bakker

Ron T Gansevoort

Isabelle C Van Gelder

Michiel Rienstra

Affiliations

Soon will be listed here.

Abstract

Objective: Atrial fibrillation (AF) is a condition that occurs in the presence of comorbidities. With the accumulation of comorbidities (multimorbidity), some combinations may more often occur together than others. Information on the impact of clustering of these on incident AF is sparse. We aimed to investigate clustering of cardiovascular and renal comorbidities and study the association between comorbidity clusters and incident AF.

Methods: We used the community-based Prevention of Renal and Vascular ENd-stage Disease (PREVEND) cohort in which 8592 individuals participated. Latent class analysis was performed to assess clustering of 10 cardiovascular and renal comorbidities.

Results: We excluded individuals with prior AF or missing ECG data, leaving 8265 individuals for analysis (mean age 48.9±12.6 years, 50.2% women). During 9.2±2.1 years of follow-up, 251 individuals (3.0%) developed AF. A model with three clusters was the optimal model, with one cluster being young (44.5±10.8 years) and healthy, carrying a low (1.0%) risk of incident AF; one cluster being older (63.0±8.4 years) and multimorbid, carrying a high (16.2%) risk of incident AF and a third middle-aged (57.0±11.3 years), obese and hypertensive cluster carrying an intermediate risk (5.9%) of incident AF. While the prevalence of the comorbidities differed between classes, no clear combination(s) of comorbidities was observed within the classes.

Conclusions: We identified three clusters of comorbidities in individuals in the community-based PREVEND cohort. The three clusters contained different amount of comorbidities carrying different risks of incident AF. However, there were no differences between the clusters regarding specific combination(s) of comorbidities.

Citing Articles

Multimorbidity in patients with atrial fibrillation.

Lobeek M, Middeldorp M, Van Gelder I, Rienstra M Open Heart. 2024; 11(1).

PMID: 38508658 PMC: 10952871. DOI: 10.1136/openhrt-2024-002641.

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