A large meta-analysis in The BMJ recently has shown that an irregular heartbeat, known as atrial fibrillation, is associated with a wide range of serious health issues, including heart attacks, heart failure, chronic kidney disease, and sudden cardiac death.

Other risks greater than stroke

The findings, by the University of Oxford in the United Kingdom and the Massachusetts Institute of Technology in the United States, shows that the risk of non-stroke factors is greater than that of stroke – which is a previously known risk of atrial fibrillation.

The results have prompted researchers to call for greater interventions to reduce the risk of non-stroke health issues for those diagnosed with atrial fibrillation.

Besides the fact that people living with atrial fibrillation would suffer from an increased risk of stroke and death, they would experience higher medical costs and a reduced quality of life. This new study provides a new insight into the wide ramifications of atrial fibrillation by quantifying the associations between AF and cardiovascular disease, kidney disease, and death.

The researchers sieved through the results of 104 studies involving over nine million cases. Of these, there were 580,000 atrial fibrillation cases, and the irregular heartbeat condition was associated with an increased risk of ischaemic heart disease, chronic kidney disease, heart failure, and sudden cardiac death.

Detailed risk results

The marginal risk increments that the study has found are detailed below:

• 3.8 per 1,000 years for all, cause mortality,
• 1.4 per 1,000 years for ischaemic heart disease,
• 6.6 per 1,000 years for chronic kidney disease,
• 11 per 1,000 years for heart failure, (the highest amongst all risks)
• Three times higher risk of cardiovascular mortality,
• 2.3 times higher risk of stroke,
• Five times higher risk of incident congestive heart failure.

Importance of more research into atrial fibrillation

The researchers emphasised that the risk increases associated with non-stroke outcomes is more significant, than that of stroke, and say their study "adds to the growing literature on the association between atrial fibrillation and cardiovascular outcomes beyond stroke."

Despite unable to establish causality for their conclusions, they stressed that "there is merit in developing clinical risk prediction models for outcomes such as congestive heart failure; particularly given our relative and absolute risk estimates.”

The researchers would like to highlight that their study could pave the way for the prioritisation of public health resources towards atrial fibrillation, and the development of new treatments for adults living with the condition.

In Singapore, it is estimated that more than 55,000 people are living with atrial fibrillation, and is projected that as many as one in four individuals above the age of 40 would eventually develop the heart condition. MIMS



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