Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study
Background: Atrial fibrillation (AF) and heart failure (HF) often coexist and impact morbidity and mortality. There is limited knowledge on the association of AF subtypes with HF according to sex. Objectives: The purpose of this study was to explore sex-specific associations between AF subtypes and...
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Elsevier
2025-02-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X24008378 |
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| author | Hilde Espnes, MD Tom Wilsgaard, PhD Jocasta Ball, PhD Maja-Lisa Løchen, MD, PhD Inger Njølstad, MD, PhD Renate B. Schnabel, MD, MSc Eva Gerdts, MD, PhD Ekaterina Sharashova, MD, PhD |
| author_facet | Hilde Espnes, MD Tom Wilsgaard, PhD Jocasta Ball, PhD Maja-Lisa Løchen, MD, PhD Inger Njølstad, MD, PhD Renate B. Schnabel, MD, MSc Eva Gerdts, MD, PhD Ekaterina Sharashova, MD, PhD |
| author_sort | Hilde Espnes, MD |
| collection | DOAJ |
| description | Background: Atrial fibrillation (AF) and heart failure (HF) often coexist and impact morbidity and mortality. There is limited knowledge on the association of AF subtypes with HF according to sex. Objectives: The purpose of this study was to explore sex-specific associations between AF subtypes and subsequent HF, identifying HF risk factors in participants with AF, and exploring the combined impact on mortality. Methods: 14,790 women and 13,181 men from the Tromsø Study were enrolled between 1994 and 2008 and followed for incident AF and HF through 2016. Cox regression was conducted to provide HRs and 95% CIs. Results: Those with AF had higher risk of subsequent HF in both sexes compared to those without AF. Women with permanent AF had higher relative risk of HF than men (HR: 10.52; 95% CI: 8.72-12.70, and HR: 7.65; 95% CI: 6.40-9.15, respectively). Risk factors for HF in participants with AF included smoking in all, higher diastolic blood pressure and hypertension in women, underweight, obesity, and low alcohol consumption in men. All-cause mortality was higher in women with both subtypes (paroxysmal/persistent: HR: 2.10; 95% CI: 1.78-2.48, permanent: HR: 1.40, 95% CI: 1.14-1.72) and in men with paroxysmal/persistent AF (HR: 1.66; 95% CI: 1.40-1.96). Subsequent HF increased risk of mortality in both sexes. Conclusions: All AF subtypes were associated with increased risk of HF. Smoking was a shared risk factor, while diastolic blood pressure and hypertension were specific to women, and underweight, obesity, and low alcohol intake were specific to men. Subsequent HF increased mortality risk in all. |
| format | Article |
| id | doaj-art-5c1a8da327cd43c1bf4e4bf961d1eeea |
| institution | Kabale University |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
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| series | JACC: Advances |
| spelling | doaj-art-5c1a8da327cd43c1bf4e4bf961d1eeea2025-01-12T05:26:21ZengElsevierJACC: Advances2772-963X2025-02-0142101556Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø StudyHilde Espnes, MD0Tom Wilsgaard, PhD1Jocasta Ball, PhD2Maja-Lisa Løchen, MD, PhD3Inger Njølstad, MD, PhD4Renate B. Schnabel, MD, MSc5Eva Gerdts, MD, PhD6Ekaterina Sharashova, MD, PhD7Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Address for correspondence: Dr Hilde Espnes, Department of Community Medicine, UiT The Arctic University of Norway, PO box 6050 Stakkevollan, Tromsø N-9037, Norway.Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, NorwaySchool of Public Health and Preventive Medicine, Monash University, Melbourne, AustraliaDepartment of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of Community Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of Cardiology, University Heart and Vascular Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Berlin, GermanyDepartment of Clinical Science, University of Bergen, Bergen, NorwayDepartment of Community Medicine, UiT The Arctic University of Norway, Tromsø, NorwayBackground: Atrial fibrillation (AF) and heart failure (HF) often coexist and impact morbidity and mortality. There is limited knowledge on the association of AF subtypes with HF according to sex. Objectives: The purpose of this study was to explore sex-specific associations between AF subtypes and subsequent HF, identifying HF risk factors in participants with AF, and exploring the combined impact on mortality. Methods: 14,790 women and 13,181 men from the Tromsø Study were enrolled between 1994 and 2008 and followed for incident AF and HF through 2016. Cox regression was conducted to provide HRs and 95% CIs. Results: Those with AF had higher risk of subsequent HF in both sexes compared to those without AF. Women with permanent AF had higher relative risk of HF than men (HR: 10.52; 95% CI: 8.72-12.70, and HR: 7.65; 95% CI: 6.40-9.15, respectively). Risk factors for HF in participants with AF included smoking in all, higher diastolic blood pressure and hypertension in women, underweight, obesity, and low alcohol consumption in men. All-cause mortality was higher in women with both subtypes (paroxysmal/persistent: HR: 2.10; 95% CI: 1.78-2.48, permanent: HR: 1.40, 95% CI: 1.14-1.72) and in men with paroxysmal/persistent AF (HR: 1.66; 95% CI: 1.40-1.96). Subsequent HF increased risk of mortality in both sexes. Conclusions: All AF subtypes were associated with increased risk of HF. Smoking was a shared risk factor, while diastolic blood pressure and hypertension were specific to women, and underweight, obesity, and low alcohol intake were specific to men. Subsequent HF increased mortality risk in all.http://www.sciencedirect.com/science/article/pii/S2772963X24008378atrial fibrillationcohort studyheart failuresex differences |
| spellingShingle | Hilde Espnes, MD Tom Wilsgaard, PhD Jocasta Ball, PhD Maja-Lisa Løchen, MD, PhD Inger Njølstad, MD, PhD Renate B. Schnabel, MD, MSc Eva Gerdts, MD, PhD Ekaterina Sharashova, MD, PhD Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study JACC: Advances atrial fibrillation cohort study heart failure sex differences |
| title | Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study |
| title_full | Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study |
| title_fullStr | Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study |
| title_full_unstemmed | Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study |
| title_short | Heart Failure in Atrial Fibrillation Subtypes in Women and Men in the Tromsø Study |
| title_sort | heart failure in atrial fibrillation subtypes in women and men in the tromso study |
| topic | atrial fibrillation cohort study heart failure sex differences |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X24008378 |
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