News: Heart failure surpasses stroke as most common AF complication

The lifetime risk of atrial fibrillation (AF) increased from 2000 to 2022 from one in four to one in three, and heart failure was the most common complication linked to it, according to a recent study published in BMJ. The study also found that lifetime risks of post-AF stroke, ischemic stroke, and myocardial infarction only showed modest improvement over time and remained high, with a lifetime risk of two in five for heart failure, twice that of stroke, Medscape Medical News reported.

The study followed 3.5 million individuals aged 45 or older who did not have AF, who were then followed until incident AF, migration, death, or the end of follow-up. Of that population, 362,721 individuals with incident AF but no prevalent complication were further followed over two time periods (2000-2010 and 2011-2020) until incident heart failure, stroke, or myocardial infarction.

In result, the study found:

• Lifetime AF risk increased from 24.2% in 2000-2010 to 30.9% in 2011-2022, for a difference of 6.7%.
• Lifetime AF risk rose across all subgroups over time, with a larger increase in men and individuals with heart failure, myocardial infarction, stroke, diabetes, and chronic kidney disease.
• Lifetime risk of heart failure was 42.9% in 2000-2010 and 42.1% in 2011-2022, for a difference of −0.8%.
• The lifetime risks of post-AF stroke and of myocardial infarction decreased slightly between the two periods, from 22.4% to 19.9% for stroke and from 13.7% to 9.8% for myocardial infarction. No differential decrease between men and women emerged.

“The substantial lifetime risk of heart failure following atrial fibrillation necessitates heightened attention to its prevention and early detection,” said Nicklas Vinter, MD, PhD, a postdoctoral researcher at the Danish Center for Health Service Research in the Department of Clinical Medicine at Aalborg University, Denmark, and lead researcher of the study. “Furthermore, the high lifetime risk of stroke remains a critical complication, which highlights the importance of continuous attention to the initiation and maintenance of oral anticoagulation therapy.”

Editor’s note: To read Medscape Medical News’ coverage of this story, click here. To access the BMJ study, click here.