Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study
Introduction: Multimorbidity is common in patients with atrial fibrillation (AF), but data on its prevalence and impact in permanent AF is limited. This study aimed to investigate the prevalence of multimorbidity and its association with cardiovascular outcomes in recent-onset permanent AF. Methods:...
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Elsevier
2025-08-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906725000892 |
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| author | Colinda van Deutekom Marieke J.H. Velt Isabelle C. van Gelder Michiel Rienstra Bart A. Mulder |
| author_facet | Colinda van Deutekom Marieke J.H. Velt Isabelle C. van Gelder Michiel Rienstra Bart A. Mulder |
| author_sort | Colinda van Deutekom |
| collection | DOAJ |
| description | Introduction: Multimorbidity is common in patients with atrial fibrillation (AF), but data on its prevalence and impact in permanent AF is limited. This study aimed to investigate the prevalence of multimorbidity and its association with cardiovascular outcomes in recent-onset permanent AF. Methods: The RACE II study was a randomized controlled trial comparing strict and lenient rate-control in 614 patients with recent-onset permanent AF. Presence of nine comorbidities was assessed and the population divided into three groups based on the number of comorbidities (0–1, 2–3, ≥4). Cox regression analyses were conducted to assess the association between the number of comorbidities and the primary composite outcome (cardiovascular mortality, hospitalization for heart failure, stroke and/or systemic embolism, major bleeding, arrhythmic events). Kaplan-Meier estimates for the cumulative risk of the first event were calculated and plotted. Results: Mean age was 68 ± 8 years and 211 (34 %) were women. In this population, 213 (35 %) patients had 0–1 comorbidity, 313 (51 %) 2–3, and 88 (14 %) ≥ 4. During 3 years follow-up, 81 patients (13 %) reached the primary composite outcome. Patients with more comorbidities more frequently reached the primary composite outcome (P < 0.001), as well as cardiovascular mortality (P = 0.049), heart failure hospitalizations (P = 0.003), and stroke/systemic embolism (P = 0.024). The presence of ≥ 4 comorbidities was associated with a higher risk of the primary composite outcome compared to the presence of 0–1 comorbidity (HR 2.27, 95 % CI (1.21–4.23), P = 0.010). Conclusion: Multimorbidity was present in two-thirds of recent-onset permanent AF patients, with a higher number of comorbidities associated with greater risk of cardiovascular outcomes. |
| format | Article |
| id | doaj-art-f5ab8dbb72a84c29a0ddccef32b82c66 |
| institution | DOAJ |
| issn | 2352-9067 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-f5ab8dbb72a84c29a0ddccef32b82c662025-08-20T02:56:29ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-08-015910168610.1016/j.ijcha.2025.101686Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II studyColinda van Deutekom0Marieke J.H. Velt1Isabelle C. van Gelder2Michiel Rienstra3Bart A. Mulder4Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsCorresponding author at: Department of Cardiology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands.; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsIntroduction: Multimorbidity is common in patients with atrial fibrillation (AF), but data on its prevalence and impact in permanent AF is limited. This study aimed to investigate the prevalence of multimorbidity and its association with cardiovascular outcomes in recent-onset permanent AF. Methods: The RACE II study was a randomized controlled trial comparing strict and lenient rate-control in 614 patients with recent-onset permanent AF. Presence of nine comorbidities was assessed and the population divided into three groups based on the number of comorbidities (0–1, 2–3, ≥4). Cox regression analyses were conducted to assess the association between the number of comorbidities and the primary composite outcome (cardiovascular mortality, hospitalization for heart failure, stroke and/or systemic embolism, major bleeding, arrhythmic events). Kaplan-Meier estimates for the cumulative risk of the first event were calculated and plotted. Results: Mean age was 68 ± 8 years and 211 (34 %) were women. In this population, 213 (35 %) patients had 0–1 comorbidity, 313 (51 %) 2–3, and 88 (14 %) ≥ 4. During 3 years follow-up, 81 patients (13 %) reached the primary composite outcome. Patients with more comorbidities more frequently reached the primary composite outcome (P < 0.001), as well as cardiovascular mortality (P = 0.049), heart failure hospitalizations (P = 0.003), and stroke/systemic embolism (P = 0.024). The presence of ≥ 4 comorbidities was associated with a higher risk of the primary composite outcome compared to the presence of 0–1 comorbidity (HR 2.27, 95 % CI (1.21–4.23), P = 0.010). Conclusion: Multimorbidity was present in two-thirds of recent-onset permanent AF patients, with a higher number of comorbidities associated with greater risk of cardiovascular outcomes.http://www.sciencedirect.com/science/article/pii/S2352906725000892Atrial fibrillationMultimorbidityComorbiditiesCardiovascular outcomesMortality |
| spellingShingle | Colinda van Deutekom Marieke J.H. Velt Isabelle C. van Gelder Michiel Rienstra Bart A. Mulder Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study International Journal of Cardiology: Heart & Vasculature Atrial fibrillation Multimorbidity Comorbidities Cardiovascular outcomes Mortality |
| title | Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study |
| title_full | Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study |
| title_fullStr | Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study |
| title_full_unstemmed | Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study |
| title_short | Multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation: Data from the RACE II study |
| title_sort | multimorbidity increases risk of cardiovascular outcomes in permanent atrial fibrillation data from the race ii study |
| topic | Atrial fibrillation Multimorbidity Comorbidities Cardiovascular outcomes Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2352906725000892 |
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