Pattara Rattanawong1,2, Sikarin Upala3,4, Tanawan Riangwiwat1, Veeravich Jaruvongvanich1, Anawin Sanguankeo5,6, Wasawat Vutthikraivit2,7, Eugene H Chung8. 1. University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA. 2. Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 3. Section of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Chicago, Chicago, IL, USA. sikarinu@gmail.com. 4. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikarinu@gmail.com. 5. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 6. Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 7. Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA. 8. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Abstract
PURPOSE: Recent studies suggest that atrial fibrillation (AF) is associated with increased cardiovascular risk and mortality including sudden cardiac death (SCD). According to the Cardiovascular Heath Study cohort, the incident rate of SCD was higher in the AF population (2.9 per 1000 per year) compared with non-AF controls (1.3 per 1000 per year). In this study, we performed a systematic review and meta-analysis to explore the association between AF and SCD. METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to January 2017. Included studies were published prospective or retrospective cohort studies that compared the risk of developing SCD, defined by World Health Organization's criteria, in AF patients versus non-AF patients. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate the risk ratios and 95% confidence intervals. RESULTS: Twenty-seven studies from January 1991 to February 2017 involving 8401 AF patients and 67,608 non-AF controls were included in this meta-analysis. Compared with controls, AF patients had a significantly higher risk of SCD in overall analysis (pooled risk ratio = 2.04, 95% confidence interval: 1.77-2.35, p < 0.01, I2 = 42.66) as well as subgroups of general population studies, previous myocardial infarction or coronary artery disease, heart failure, hypertrophic cardiomyopathy (HCM), Brugada syndrome, and patients with either a pacemaker or implantable cardioverter defibrillator (ICD). In subgroup analysis of multivariate-adjusted studies, AF also had a significantly higher risk of SCD (pooled risk ratio = 2.22, 95% confidence interval = 1.59-3.09, p < 0.01, I2 = 73.95). Incident rate of SCD in AF was 2-fold higher than controls but not statistically significant (pooled rate ratio = 2.06, 95% confidence interval = 0.66-7.53, p = 0.292, I2 = 88.58). CONCLUSIONS: Our meta-analysis demonstrates a statistically significant increased risk of SCD with AF in the general population and in those with previous myocardial infarction, coronary artery disease, heart failure, HCM, Brugada syndrome, and an implanted rhythm device.
PURPOSE: Recent studies suggest that atrial fibrillation (AF) is associated with increased cardiovascular risk and mortality including sudden cardiac death (SCD). According to the Cardiovascular Heath Study cohort, the incident rate of SCD was higher in the AF population (2.9 per 1000 per year) compared with non-AF controls (1.3 per 1000 per year). In this study, we performed a systematic review and meta-analysis to explore the association between AF and SCD. METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to January 2017. Included studies were published prospective or retrospective cohort studies that compared the risk of developing SCD, defined by World Health Organization's criteria, in AFpatients versus non-AFpatients. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate the risk ratios and 95% confidence intervals. RESULTS: Twenty-seven studies from January 1991 to February 2017 involving 8401 AFpatients and 67,608 non-AF controls were included in this meta-analysis. Compared with controls, AFpatients had a significantly higher risk of SCD in overall analysis (pooled risk ratio = 2.04, 95% confidence interval: 1.77-2.35, p < 0.01, I2 = 42.66) as well as subgroups of general population studies, previous myocardial infarction or coronary artery disease, heart failure, hypertrophic cardiomyopathy (HCM), Brugada syndrome, and patients with either a pacemaker or implantable cardioverter defibrillator (ICD). In subgroup analysis of multivariate-adjusted studies, AF also had a significantly higher risk of SCD (pooled risk ratio = 2.22, 95% confidence interval = 1.59-3.09, p < 0.01, I2 = 73.95). Incident rate of SCD in AF was 2-fold higher than controls but not statistically significant (pooled rate ratio = 2.06, 95% confidence interval = 0.66-7.53, p = 0.292, I2 = 88.58). CONCLUSIONS: Our meta-analysis demonstrates a statistically significant increased risk of SCD with AF in the general population and in those with previous myocardial infarction, coronary artery disease, heart failure, HCM, Brugada syndrome, and an implanted rhythm device.
Entities:
Keywords:
Atrial fibrillation; Sudden cardiac death
Authors: Kenneth M Stein; David E Euler; Rahul Mehra; Karlheinz Seidl; David J Slotwiner; Suneet Mittal; Steven M Markowitz; Bruce B Lerman Journal: J Am Coll Cardiol Date: 2002-07-17 Impact factor: 24.094
Authors: Lin Y Chen; Nona Sotoodehnia; Petra Bůžková; Faye L Lopez; Laura M Yee; Susan R Heckbert; Ronald Prineas; Elsayed Z Soliman; Selcuk Adabag; Suma Konety; Aaron R Folsom; David Siscovick; Alvaro Alonso Journal: JAMA Intern Med Date: 2013-01-14 Impact factor: 21.873
Authors: Alon Eisen; Christian T Ruff; Eugene Braunwald; Francesco Nordio; Ramón Corbalán; Anthony Dalby; Maria Dorobantu; Michele Mercuri; Hans Lanz; Howard Rutman; Stephen D Wiviott; Elliott M Antman; Robert P Giugliano Journal: J Am Heart Assoc Date: 2016-07-08 Impact factor: 5.501
Authors: Roman Załuska; Anna Milewska; Anastasius Moumtzoglou; Marcin Grabowski; Wojciech Drygas Journal: Medicina (Kaunas) Date: 2022-01-19 Impact factor: 2.430
Authors: Jens Cosedis Nielsen; Yenn-Jiang Lin; Marcio Jansen de Oliveira Figueiredo; Alireza Sepehri Shamloo; Alberto Alfie; Serge Boveda; Nikolaos Dagres; Dario Di Toro; Lee L Eckhardt; Kenneth Ellenbogen; Carina Hardy; Takanori Ikeda; Aparna Jaswal; Elizabeth Kaufman; Andrew Krahn; Kengo Kusano; Valentina Kutyifa; Han S Lim; Gregory Y H Lip; Santiago Nava-Townsend; Hui-Nam Pak; Gerardo Rodríguez Diez; William Sauer; Anil Saxena; Jesper Hastrup Svendsen; Diego Vanegas; Marmar Vaseghi; Arthur Wilde; T Jared Bunch; Alfred E Buxton; Gonzalo Calvimontes; Tze-Fan Chao; Lars Eckardt; Heidi Estner; Anne M Gillis; Rodrigo Isa; Josef Kautzner; Philippe Maury; Joshua D Moss; Gi-Byung Nam; Brian Olshansky; Luis Fernando Pava Molano; Mauricio Pimentel; Mukund Prabhu; Wendy S Tzou; Philipp Sommer; Janice Swampillai; Alejandro Vidal; Thomas Deneke; Gerhard Hindricks; Christophe Leclercq Journal: Europace Date: 2020-08-01 Impact factor: 5.214
Authors: Ramkumar V Venkateswaran; M V Moorthy; Neal A Chatterjee; Julie Pester; Alan H Kadish; Daniel C Lee; Nancy R Cook; Christine M Albert Journal: JACC Clin Electrophysiol Date: 2021-07-28