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Comparison of risk profiles for new-onset atrial fibrillation between patients aged <60 and ≥60 years

 In-Soo Kim  ;  Yeon-Jik Choi  ;  Eui-Young Choi  ;  Pil-Ki Min  ;  Young Won Yoon  ;  Byoung Kwon Lee  ;  Bum-Kee Hong  ;  Se-Joong Rim  ;  Hyuck Moon Kwon  ;  Jong-Youn Kim 
 PLOS ONE, Vol.16(11) : e0258770, 2021-11 
Journal Title
Issue Date
Adult ; Age Factors ; Age of Onset ; Aged ; Atrial Fibrillation / complications ; Atrial Fibrillation / epidemiology* ; Atrial Fibrillation / physiopathology ; Body Mass Index ; Female ; Heart Failure / complications ; Heart Failure / epidemiology* ; Heart Failure / physiopathology ; Humans ; Hypertension / complications ; Hypertension / epidemiology ; Hypertension / physiopathology ; Male ; Middle Aged ; Obesity / complications ; Obesity / epidemiology ; Obesity / physiopathology ; Pulmonary Disease, Chronic Obstructive / complications ; Pulmonary Disease, Chronic Obstructive / epidemiology ; Pulmonary Disease, Chronic Obstructive / physiopathology ; Renal Insufficiency, Chronic / complications ; Renal Insufficiency, Chronic / epidemiology ; Renal Insufficiency, Chronic / physiopathology ; Republic of Korea / epidemiology ; Risk Factors ; Stroke / complications ; Stroke / epidemiology* ; Stroke / physiopathology
Background: Atrial fibrillation (AF) has a heterogeneous pathophysiology according to individual patient characteristics. This study aimed to identify the effects of widely known risk factors on AF incidence according to age and to elucidate the clinical implications of these effects.

Methods and results: We analyzed data from 501,668 subjects (≥18years old) without AF and valvular heart disease from the Korean National Health Insurance Service-National Sample Cohort. The total population was divided into two groups according to age, <60years and ≥60years. AF occurred in 0.7% of the overall population (3,416 of 501,668) during the follow-up period (mean 47.6 months). In Cox regression analysis, age, male sex, previous ischemic stroke, heart failure, and hypertension were related to increased risk of new-onset AF in both age groups. Especially in the <60years age group, risk of new-onset AF was increased by relatively modifiable risk factors: obesity (body mass index ≥25kg/m2; hazard ratio[HR] 1.37 [1.22-1.55], p<0.001, interaction p<0.001), and hypertension (HR 1.93[1.69-2.22], p<0.001, interaction p<0.001). Although interactions were not significant, chronic obstructive pulmonary disease (HR 1.41[1.24-1.60], p<0.001) and chronic kidney disease (HR 1.28[1.15-1.41], p<0.001) showed increased trends of the risk of new-onset AF in the ≥60years age group.

Conclusion: The risk profile for new-onset AF was somewhat different between the <60years and the ≥60years age groups. Compared to the ≥60years group, relatively modifiable risk factors (such as obesity and hypertension) had a greater impact on AF incidence in the <60years age group. Different management strategies to prevent AF development according to age may be needed.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Yoon, Young Won(윤영원) ORCID logo https://orcid.org/0000-0002-0907-0350
Lee, Byoung Kwon(이병권) ORCID logo https://orcid.org/0000-0001-9259-2776
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Hong, Bum Kee(홍범기) ORCID logo https://orcid.org/0000-0002-6456-0184
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