| アブストラクト | OBJECTIVE: Risk-guided atrial fibrillation (AF) screening may be an opportunity to prevent adverse events in addition to stroke. We compared events rates for new diagnoses of cardio-renal-metabolic diseases and death in individuals identified at higher versus lower-predicted AF risk. METHODS: From the UK Clinical Practice Research Datalink-GOLD dataset, 2 January 1998-30 November 2018, we identified individuals aged >/=30 years without known AF. The risk of AF was estimated using the FIND-AF (Future Innovations in Novel Detection of Atrial Fibrillation) risk score. We calculated cumulative incidence rates and fit Fine and Gray's models at 1, 5 and 10 years for nine diseases and death adjusting for competing risks. RESULTS: Of 416 228 individuals in the cohort, 82 942 were identified as higher risk for AF. Higher-predicted risk, compared with lower-predicted risk, was associated with incident chronic kidney disease (cumulative incidence per 1000 persons at 10 years 245.2; HR 6.85, 95% CI 6.70 to 7.00; median time to event 5.44 years), heart failure (124.7; 12.54, 12.08 to 13.01; 4.06), diabetes mellitus (123.3; 2.05, 2.00 to 2.10; 3.45), stroke/transient ischaemic attack (118.9; 8.07, 7.80 to 8.34; 4.27), myocardial infarction (69.6; 5.02, 4.82 to 5.22; 4.32), peripheral vascular disease (44.6; 6.62, 6.28 to 6.98; 4.28), valvular heart disease (37.8; 6.49, 6.14 to 6.85; 4.54), aortic stenosis (18.7; 9.98, 9.16 to 10.87; 4.41) and death from any cause (273.9; 10.45, 10.23 to 10.68; 4.75). The higher-risk group constituted 74% of deaths from cardiovascular or cerebrovascular causes (8582 of 11 676). CONCLUSIONS: Individuals identified for risk-guided AF screening are at risk of new diseases across the cardio-renal-metabolic spectrum and death, and may benefit from interventions beyond ECG monitoring. |
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| ジャーナル名 | Open heart |
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| 投稿日 | 2023/7/11 |
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| 投稿者 | Wu, Jianhua; Nadarajah, Ramesh; Nakao, Yoko M; Nakao, Kazuhiro; Hogg, David; Raveendra, Keerthenan; Arbel, Ronen; Haim, Moti; Zahger, Doron; Cowan, Campbel; Gale, Chris P |
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| 組織名 | School of Dentistry, University of Leeds, Leeds, UK.;Leeds Institute of Data Analytics, University of Leeds, Leeds, UK;r.nadarajah@leeds.ac.uk.;Department of Cardiology, Leeds General Infirmary, Leeds, UK.;Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.;Department of Cardiovascular Medicine, National Cerebral and Cardiovascular;Center, Suita, Japan.;School of Computing, University of Leeds, Leeds, UK.;Medical School, University of Leeds, Leeds, UK.;Sapir College, Hof Ashkelon, Israel.;Community Medical Services Division, Clalit Health Services, Tel Aviv, Israel.;Department of Cardiology, Soroka University Medical Center, Beer Sheva, Israel.;Ben-Gurion University of the Negev, Beer Sheva, Israel. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37429702/ |
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