Arrhythmias & electrophysiology
Phenotype-guided risk stratification in anticoagulated atrial fibrillation patients: Cluster analysis of the Murcia atrial fibrillation (AF) Project III (MAFP-III)
Main finding · Thromboembolic eventsResult — go to the resultAdjusted hazard ratio 3.31 95% CI 1.96–5.57Authors' conclusion
Cluster analysis revealed distinct phenotypic profiles among patients with AF, each associated with differential risks of adverse outcomes.
Study context
- Population
- Patients with anticoagulated AF, included between January 2016 and November 2021patients with AF (median age 77, IQR 70–83 years, 52.8% women)
- Participants
- 3,259 patients
- Comparison
- Phenotypic clusters compared with Cluster 1
- Outcome
- Thromboembolic events
- Follow-up
- 2-year follow-up
Methodological detailsprospectively included, hierarchical clustering, adjusted Cox models
- Prospectively included
- Hierarchical clustering
- Adjusted Cox models
Main finding
As reported in the abstract
Adjusted hazard ratio
3.31
95% CI 1.96–5.57
Cluster 5vs Cluster 1
aHR 3.31 (95% CI 1.96–5.57)
- aHR range vs Cluster 1
- 2.37-3.31
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Major bleeding · 2-year follow-upCluster 5vs Cluster 1Adjusted Cox models | 4.73 (2.51–8.91) | |
| MACE · 2-year follow-upCluster 5vs Cluster 1Adjusted Cox models | 4.13 (2.62–6.51) | |
| Cardiovascular death · 2-year follow-upCluster 5vs Cluster 1Adjusted Cox models | 6.82 (3.05–15.27) | |
| All-cause death · 2-year follow-upCluster 5vs Cluster 1Adjusted Cox models | 4.18 (2.77–6.31) | |
| 0.050.21520Adjusted hazard ratio (log scale) |
- Major bleeding — aHR range vs Cluster 1
- 3.34-4.73
- Major adverse cardiovascular events (MACE) — aHR range vs Cluster 1
- 2.64-4.13
- Cardiovascular death — aHR range vs Cluster 1
- 4.29-6.82
- All-cause death — aHR range vs Cluster 1
- 2.47-4.18
Cluster identification
- Five phenotypic clusters were identified
- Cluster 5 consistently exhibited the highest relative risk across all outcomes
Original publication
Phenotype-guided risk stratification in anticoagulated atrial fibrillation patients: Cluster analysis of the Murcia AF Project III (MAFP-III). Heart Rhythm. Published 11 September 2025. doi:10.
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