Abstract 16861: History of Atrial Fibrillation in a First-degree Relative and Risk of Cardiovascular Events
Introduction: Familial atrial fibrillation (AF) has been shown to be a risk factor for new-onset AF. The association between familial AF and cardiovascular events (CVEs) in a large cohort of AF patients has never been investigated.
Hypothesis: To test the association between familial AF and CVEs.
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 during a median follow-up of 24 months.
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 years, respectively p<0.001). Moreover, AF patients with multiple familial AF showed an even earlier onset of AF compared to those with single familial AF (60.7±12.3 vs. 66.2±10.1 years, respectively p=0.003). Patients with familial AF experienced a higher rate of CVEs compared non-familial ones (13.5% vs. 8.0%, 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) were independently associated with CVEs.
Conclusions: Our study show a previously unrecognized high prevalence of familial AF, which confers an increased risk for CVEs. Screening for familial AF could improve strategies to lower vascular outcomes.
Author Disclosures: D. Pastori: None. P. Pignatelli: None. T. Vicario: None. D. Menichelli: None. F. Perticone: None. A. Sciacqua: None. F. Violi: None.
- © 2016 by American Heart Association, Inc.