Author + information
- Daniele Pastoria,b,
- Pasquale Pignatellia,b,
- Tommasa Vicarioa,b,
- Danilo Menichellia,b,
- Francesco Perticonea,b,
- Angela Sciacquaa,b and
- Francesco Violia,b
Background: Familial atrial fibrillation (AF) has been shown to be a risk factor for new-onset AF. The association between the presence of familial AF and cardiovascular events (CVEs) in a large cohort of elderly patients with AF has never been investigated.
Methods: Prospective multicenter cohort study including 1309 anticoagulated AF patients. Familial AF was defined as the presence of known history of AF in a first-degree family member: parents, sibling, or children. Primary outcome was a composite of CVEs including fatal/non-fatal ischemic stroke and myocardial infarction, arterial revascularization (both cardiac and peripheral) and cardiovascular death.
Results: Mean age was 73.2±9.1 years and 44% were women; 19 patients were excluded for missing informations about family history. Familial AF was present in 259 (20.1%) patients; in 14,3% of familial cases, more than 1 relative had a history of AF. Patients with familial AF had an earlier onset of AF compared to non-familial (70.4±9.9 vs. 65.4±10.6, respectively p<0.001). Moreover, AF patients with multiple familial AF showed a further early onset of AF compared to those with single familial AF (60.7±12.3 vs. 66.2±10.1, respectively p=0.003). The presence of familial AF was associated with an increased rate of CVEs (n=117) at a median follow-up of 24 months (Log-rank test, p=0.024). At Cox multivariable regression analysis, familial AF (HR 1.99 95%CI 1.32-3.02, p=0.001), male gender (HR 1.61 95%CI 1.09-2.37, p=0.017), age (HR 1.08, 95%CI 1.05-1.11, p<0.001), previous stroke/TIA (HR 1.67 95%CI 1.08-2.59, p=0.022), previous myocardial infarction (HR 1.58, 95%CI 1.05-2.38, p=0.028), heart failure (HR 1.66, 95%CI 1.07-2.56, p=0.022), after adjustment for arterial hypertension and diabetes.
Conclusions: Our study shows a previously unrecognized high prevalence of familial AF, which is associated with an increased risk for CVEs. These results claim for the need of recognizing patients with familial AF, as to plan appropriate and cost-effective prevention strategies.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Specific Situations and Newer Outcome Measures
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1190-105
- 2017 American College of Cardiology Foundation