Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study
Background Multimorbidity is common among patients with atrial fibrillation (AF) and is associated with worse outcomes. We aimed to investigate the association between multimorbidity, AF progression and AF symptom severity in patients with paroxysmal AF. Methods and Results The RACE V (Reappraisal o...
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Wiley
2025-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.034514 |
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| author | Colinda van Deutekom Martijn E. van de Lande Rajiv Rama Bao‐Oanh Nguyen Robert G. Tieleman Vanessa Weberndörfer Martin E. W. Hemels Mirko de Melis Ulrich Schotten Dominik Linz Harry J. G. M. Crijns Isabelle C. van Gelder Michiel Rienstra |
| author_facet | Colinda van Deutekom Martijn E. van de Lande Rajiv Rama Bao‐Oanh Nguyen Robert G. Tieleman Vanessa Weberndörfer Martin E. W. Hemels Mirko de Melis Ulrich Schotten Dominik Linz Harry J. G. M. Crijns Isabelle C. van Gelder Michiel Rienstra |
| author_sort | Colinda van Deutekom |
| collection | DOAJ |
| description | Background Multimorbidity is common among patients with atrial fibrillation (AF) and is associated with worse outcomes. We aimed to investigate the association between multimorbidity, AF progression and AF symptom severity in patients with paroxysmal AF. Methods and Results The RACE V (Reappraisal of AF: Interaction Between Hypercoagulability, Electrical Remodeling, and Vascular Destabilization in the Progression of AF) study included patients with paroxysmal AF and continuous rhythm monitoring. Multimorbidity was defined as ≥2 comorbidities (heart failure, hypertension, diabetes, coronary heart disease, kidney dysfunction, moderate or severe mitral valve regurgitation, or obesity). AF symptom severity was assessed via the University of Toronto AF Severity Scale questionnaire. The associations between multimorbidity, AF progression, and AF symptom severity were determined using logistic regression analyses. Median age was 65 (58–71) years and 179 of 417 patients (43%) were women, with a median of 1 (1–2) comorbidities. Median follow‐up was 2.2 (1.6–2.8) years. Multimorbidity was associated with AF progression (odds ratio [OR], 2.02 [95% CI, 1.10–3.72], P=0.024) and increased AF symptom severity (OR, 2.67 [95% CI, 1.79–3.99], P<0.001). There was a positive dose–response relation between the number of comorbidities and AF progression (OR, 1.40 [95% CI, 1.09–1.79], P=0.008), as well as AF symptom severity (OR, 1.64 [95% CI, 1.35–1.99], P<0.001). These results remained significant after adjusting for age. Conclusions In patients with paroxysmal AF, multimorbidity was associated with AF progression and AF symptom severity. The risk of AF progression and AF symptom severity increased with every additional comorbidity. Registration URL: clinicaltrials.gov. Unique Identifier: NCT02726698. |
| format | Article |
| id | doaj-art-880f737c4b314ed8b730c5d5bee3ac28 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-880f737c4b314ed8b730c5d5bee3ac282025-08-20T03:13:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114510.1161/JAHA.123.034514Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V StudyColinda van Deutekom0Martijn E. van de Lande1Rajiv Rama2Bao‐Oanh Nguyen3Robert G. Tieleman4Vanessa Weberndörfer5Martin E. W. Hemels6Mirko de Melis7Ulrich Schotten8Dominik Linz9Harry J. G. M. Crijns10Isabelle C. van Gelder11Michiel Rienstra12Department of Cardiology, University of Groningen University Medical Centre Groningen The NetherlandsDepartment of Cardiology, University of Groningen University Medical Centre Groningen The NetherlandsDepartment of Cardiology, University of Groningen University Medical Centre Groningen The NetherlandsDepartment of Cardiology, University of Groningen University Medical Centre Groningen The NetherlandsDepartment of Cardiology Martini Hospital Groningen The NetherlandsDepartment of Cardiology Maastricht University Medical Centre+ Maastricht The NetherlandsDepartment of Cardiology Rijnstate Hospital Arnhem The NetherlandsMedtronic Bakken Research Centre Maastricht The NetherlandsCardiovascular Research Institute Maastricht (CARIM) Maastricht University Maastricht The NetherlandsDepartment of Cardiology Maastricht University Medical Centre+ Maastricht The NetherlandsDepartment of Cardiology Maastricht University Medical Centre+ Maastricht The NetherlandsDepartment of Cardiology, University of Groningen University Medical Centre Groningen The NetherlandsDepartment of Cardiology, University of Groningen University Medical Centre Groningen The NetherlandsBackground Multimorbidity is common among patients with atrial fibrillation (AF) and is associated with worse outcomes. We aimed to investigate the association between multimorbidity, AF progression and AF symptom severity in patients with paroxysmal AF. Methods and Results The RACE V (Reappraisal of AF: Interaction Between Hypercoagulability, Electrical Remodeling, and Vascular Destabilization in the Progression of AF) study included patients with paroxysmal AF and continuous rhythm monitoring. Multimorbidity was defined as ≥2 comorbidities (heart failure, hypertension, diabetes, coronary heart disease, kidney dysfunction, moderate or severe mitral valve regurgitation, or obesity). AF symptom severity was assessed via the University of Toronto AF Severity Scale questionnaire. The associations between multimorbidity, AF progression, and AF symptom severity were determined using logistic regression analyses. Median age was 65 (58–71) years and 179 of 417 patients (43%) were women, with a median of 1 (1–2) comorbidities. Median follow‐up was 2.2 (1.6–2.8) years. Multimorbidity was associated with AF progression (odds ratio [OR], 2.02 [95% CI, 1.10–3.72], P=0.024) and increased AF symptom severity (OR, 2.67 [95% CI, 1.79–3.99], P<0.001). There was a positive dose–response relation between the number of comorbidities and AF progression (OR, 1.40 [95% CI, 1.09–1.79], P=0.008), as well as AF symptom severity (OR, 1.64 [95% CI, 1.35–1.99], P<0.001). These results remained significant after adjusting for age. Conclusions In patients with paroxysmal AF, multimorbidity was associated with AF progression and AF symptom severity. The risk of AF progression and AF symptom severity increased with every additional comorbidity. Registration URL: clinicaltrials.gov. Unique Identifier: NCT02726698.https://www.ahajournals.org/doi/10.1161/JAHA.123.034514atrial fibrillationcomorbiditiesmultimorbidityprogressionsymptom severity |
| spellingShingle | Colinda van Deutekom Martijn E. van de Lande Rajiv Rama Bao‐Oanh Nguyen Robert G. Tieleman Vanessa Weberndörfer Martin E. W. Hemels Mirko de Melis Ulrich Schotten Dominik Linz Harry J. G. M. Crijns Isabelle C. van Gelder Michiel Rienstra Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation comorbidities multimorbidity progression symptom severity |
| title | Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study |
| title_full | Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study |
| title_fullStr | Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study |
| title_full_unstemmed | Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study |
| title_short | Multimorbidity Is Associated With Symptom Severity and Disease Progression in Patients with Paroxysmal Atrial Fibrillation—Data From the RACE V Study |
| title_sort | multimorbidity is associated with symptom severity and disease progression in patients with paroxysmal atrial fibrillation data from the race v study |
| topic | atrial fibrillation comorbidities multimorbidity progression symptom severity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.034514 |
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