Arrhythmias & electrophysiologyCohort study
New-onset atrial fibrillation and chronic coronary syndrome in the CLARIFY registry
- Prospective observational registry study
- international (45 countries)
- longitudinal
Authors' conclusion
Among CCS patients, NOAF is common and is strongly associated with worse outcomes.
Study context
- Population
- Chronic coronary syndromes (CCS) outpatients without previously reported AF at baseline (CLARIFY registry)
- Participants
- 29,001 outpatients
- Exposure
- New-onset AF vs sinus rhythm throughout
- Outcome
- Incidence, predictors and impact on cardiovascular (CV) outcomes of NOAF
- Follow-up
- 5-year follow-up
Main finding
As reported in the abstract
Incidence of NOAF
Incidence rate of new-onset atrial fibrillation (NOAF) per 100 patient-years
1.12 (95% CI 1.06-1.18)
Cumulative incidence at 5 years
5.0%
Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| CV outcomes with NOAF — NOAF vs Sinus rhythm · CV death, non-fatal MI or non-fatal stroke | 2.01 (1.61–2.52) | |
| CV outcomes with NOAF — NOAF vs Sinus rhythm · CV death | 2.61 (2.04–3.34) | |
| CV outcomes with NOAF — NOAF vs Sinus rhythm · non-fatal MI | 1.64 (1.07–2.50) | |
| CV outcomes with NOAF — NOAF vs Sinus rhythm · all-cause death | 2.27 (1.85–2.78) | |
| CV outcomes with NOAF — NOAF vs Sinus rhythm · hospitalization for HF | 8.44 (7.05–10.10) | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Independent predictors of NOAF
- Increasing age, increasing BMI, low eGFR, Caucasian ethnicity, alcohol intake and low LVEF predicted NOAF; high TG associated with lower incidence
Safety
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| Major bleeding | 4.46 (2.85–6.99) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Original publication
New-onset atrial fibrillation and chronic coronary syndrome in the CLARIFY registry. Eur Heart J. Published 27 August 2023. doi:10.1093/eurheartj/ehad556
Summarised from the published abstract; every number is checked against it