| アブストラクト | BACKGROUND: Age and sex influence atrial fibrillation (AF) prevalence and outcomes, yet comprehensive data on sex- and age-specific health care utilization in patients newly diagnosed with AF remain limited. OBJECTIVES: We aimed to address this gap using a phenome-wide association study (Phe-WAS) approach. METHODS: We conducted a retrospective cohort study using nationwide Clinical Practice Research Datalink data linked to Hospital Episodes Statistics. Adults diagnosed with AF between 1998 and 2016 (n = 199,433) were matched 1:1 by age and sex to non-AF control subjects. Primary and secondary care interactions 5 years post diagnosis were analyzed using Phe-WAS with Bonferroni-adjusted significance thresholds. Logistic regression estimated odds ratios for conditions in AF vs control groups, stratified by sex and age. Associations were assessed for novelty through literature review and causality using published Mendelian randomization studies. RESULTS: Patients with AF had higher rates of cardiovascular and noncardiovascular conditions than control subjects, with marked sex- and age-specific patterns. Women had more bleeding complications, pneumonia, Clostridium difficile enterocolitis, cholangitis, and electrolyte disturbances, whereas men had higher rates of alcohol-related disorders, ventricular arrhythmias, cardiac arrest, and cardiomyopathy. Younger patients with AF (<50 years) more often had alcohol-related mental and behavioral disorders, gout, and dilated cardiomyopathy, while older patients (>60 years) more often had heart failure, ischemic stroke, renal failure, and respiratory infections. Of 51 phenotypes more common in AF, 28 were previously reported, and 23 were potentially novel. Mendelian randomization analyses suggested AF was causal for 19 associations. CONCLUSIONS: This Phe-WAS demonstrates the broad spectrum of health care interactions in AF beyond traditional cardiovascular complications. |
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| ジャーナル名 | JACC. Advances |
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| Pubmed追加日 | 2026/10/23 |
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| 投稿者 | Yoshimura, Hiroyuki; Chung, Sheng-Chia; Lip, Gregory Y H; Schmidt, A Floriaan; Providencia, Rui |
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| 組織名 | Institute of Health Informatics Research, University College London, London,;United Kingdom.;Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool;John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United;Kingdom; Danish Center for Clinical Health Services Research, Department of;Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of;Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit,;Medical University of Bialystok, Bialystok, Poland.;Institute of Cardiovascular Science, Faculty of Population Health, University;College London, London, United Kingdom; UCL British Heart Foundation Center of;Excellence, London, United Kingdom; Department of Cardiology, Amsterdam;Cardiovascular Sciences, Amsterdam University Medical Centres, University of;Amsterdam, Amsterdam UMC, the Netherlands.;United Kingdom; Barts Heart Centre, Barts Health NHS Trust, London, United;Kingdom. Electronic address: r.providencia@ucl.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42913336/ |
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