Frailty increases the risk of hospitalization for atrial fibrillation in older adults: a population-based cohort study.
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Trevisan Caterina, Ceolin Chiara, Vetrano Davide Liborio, Petrovic Mirko, Lip Gregory Y H, Buchan Iain, Rui Marina De, Sergi Giuseppe, Maggi Stefania, Noale Marianna, AFFIRMO Consortium, Johnsen Søren Påske, Proietti Riccardo, Cordsen Pia, Lip Gregory, Lane Deirdre, O'Flaherty Martin, Gamble Carrol, Buchan Iain, Kypridemos Christodoulos, Collins Brendan, Leo Donato, Petrovic Mirko, Smedt Delphine De, Buyser Stefanie De, Amrouch Cheima, Vetrano Davide Liborio, Calderón-Larrañaga Amaia, Dai Lu, Maggi Stefania, Noale Marianna, Gheorghe-Andrei D A N, Dan Anca Rodica, Ferri Nicola, Buja Alessandra, Sergi Giuseppe, Rebba Vincenzo Stefano, Trevisan Caterina, Potpara Tatjana, Vivani Laura, Ananstasia Silvia, Ferri Alessandro, Shehata Gehad, Rosso Nadia, Cicerone Marco, Marczyk Jacek, Lobban Trudie, Ruppe Georg, Onder Graziano, Censi Federica, Cas Robero Da, Damiano Cecilia, Graffigna Guendalina, Bosio Caterina, Palamenghi Lorenzo, Barello Serena, Maggioni Aldo Pietro, Lorimer Andrea, Lucci Donata, Kalra Dipak, Lea Nathan, Ainsworth John, Stockton-Powdrell Charlotte, Sanaullah Alam, Marín Francisco, Roldán Vanessa, Rivera-Caravaca José Miguel, Tokmakova Mariya
Аннотация
METHODS AND RESULTS: Data from the Progetto Veneto Anziani (Pro.V.A.), an observational cohort study in north-eastern Italy, were utilised. The analyses included 2909 individuals aged ≥65 years without AF at baseline, assessed between 1995 and 1997, with follow-ups at 4.4 and 7 years. Frailty was defined according to Fried's criteria, and multimorbidity as the number of chronic diseases. AF-related hospitalizations and deaths were recorded up to December 31, 2018. Multi-adjusted mixed-effects Cox regressions were performed to test associations. Over the follow-up period, 318 (10.9 %) participants experienced AF-related hospitalizations. Compared to robust participants, the hazard ratio (HR) of hospitalizations due to AF was 1.42 (95 % Confidence Interval (95 %CI): 1.04-1.95) in pre-frail and 1.98 (95 %CI: 1.21-3.26) in frail individuals, even after adjusting for multimorbidity. The number of chronic diseases was only marginally and not significantly associated with AF-related hospitalizations (HR 1.07, 95 %CI: 0.99-1.15), but did not significantly interact with frailty in the association with AF-related hospitalizations.
CONCLUSION: Older adults with frailty present with higher hazards of AF-related hospitalizations, irrespective of the presence of multimorbidity. Further studies are needed to evaluate whether reducing frailty may prevent AF development and improve health outcomes in older adults.