Heart rhythm · 2026
Impact of anxiety and depression in patients with atrial fibrillation: Insights from 2 international prospective registries.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Rossi Michele, Bucci Tommaso, Tartaglia Enrico, Askarinejad Amir, Rigutini Andrea Galeazzo, Tse Hung-Fat, Ferri Claudio, Boriani Giuseppe, Chao Tze-Fan, Lip Gregory Y H
Аннотация
BACKGROUND: Limited data are available on the impact of anxiety and/or depression on clinical outcomes in patients with atrial fibrillation (AF).
OBJECTIVE: The purpose of this study was to compare clinical characteristics and outcomes between patients with AF with and without anxiety/depression.
METHODS: Post hoc analysis of 2 prospective registries from Europe and the Asia-Pacific. Patients were classified as asymptomatic or symptomatic for anxiety/depression. The primary outcome was a composite of all-cause death and major adverse cardiovascular events (MACEs). Secondary outcomes included all-cause death, MACE, major bleeding, and individual MACE components. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Sensitivity analyses were performed by symptom severity and across clinically relevant subgroups.
RESULTS: Of 12,614 patients (mean age 69 ± 12 years; 38% female), 4825 (38.3%; mean age 69 ± 12; 48% female) were symptomatic for anxiety/depression. Symptomatic patients with anxiety/depression were more often female, were European, and had a higher prevalence of AF-related symptoms and heart failure. After a median follow-up of 569 days (interquartile range, 365-735 days), symptomatic patients had a higher risk of the composite outcome (HR, 1.26; 95% CI, 1.10-1.45), all-cause death (HR, 1.31; 95% CI, 1.12-1.55), MACE (HR, 1.44; 95% CI, 1.19-1.74), and cardiovascular death (HR, 1.87; 95% CI, 1.41-2.47). Risk increased with symptom severity; no significant interaction was observed by geographic region or other analyzed subgroups.
CONCLUSION: In patients with AF, anxiety/depression symptoms were associated with worse clinical outcomes, with a stronger association observed in those with moderate-to-severe symptoms. These findings highlight the need for greater awareness of psychological assessment within AF management.
OBJECTIVE: The purpose of this study was to compare clinical characteristics and outcomes between patients with AF with and without anxiety/depression.
METHODS: Post hoc analysis of 2 prospective registries from Europe and the Asia-Pacific. Patients were classified as asymptomatic or symptomatic for anxiety/depression. The primary outcome was a composite of all-cause death and major adverse cardiovascular events (MACEs). Secondary outcomes included all-cause death, MACE, major bleeding, and individual MACE components. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Sensitivity analyses were performed by symptom severity and across clinically relevant subgroups.
RESULTS: Of 12,614 patients (mean age 69 ± 12 years; 38% female), 4825 (38.3%; mean age 69 ± 12; 48% female) were symptomatic for anxiety/depression. Symptomatic patients with anxiety/depression were more often female, were European, and had a higher prevalence of AF-related symptoms and heart failure. After a median follow-up of 569 days (interquartile range, 365-735 days), symptomatic patients had a higher risk of the composite outcome (HR, 1.26; 95% CI, 1.10-1.45), all-cause death (HR, 1.31; 95% CI, 1.12-1.55), MACE (HR, 1.44; 95% CI, 1.19-1.74), and cardiovascular death (HR, 1.87; 95% CI, 1.41-2.47). Risk increased with symptom severity; no significant interaction was observed by geographic region or other analyzed subgroups.
CONCLUSION: In patients with AF, anxiety/depression symptoms were associated with worse clinical outcomes, with a stronger association observed in those with moderate-to-severe symptoms. These findings highlight the need for greater awareness of psychological assessment within AF management.