Asymptomatic versus symptomatic atrial fibrillation: A systematic review of age/gender differences and cardiovascular outcomes

Up to 40% of atrial fibrillation (AF) patients are asymptomatic. Despite this, scarce data are available about asymptomatic AF, with regard to its clinical profile and relationship to cerebrovascular and cardiovascular risks. Our objective was to conduct a systematic review and meta-analysis was to...

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Vydané v:International journal of cardiology Ročník 191; s. 172 - 177
Hlavní autori: Xiong, Qinmei, Proietti, Marco, Senoo, Keitaro, Lip, Gregory Y.H.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Netherlands Elsevier Ireland Ltd 15.07.2015
Predmet:
Age Factors
Asymptomatic
Asymptomatic Diseases - mortality
Asymptomatic Diseases - therapy
Atrial fibrillation
Atrial Fibrillation - diagnosis
Atrial Fibrillation - mortality
Atrial Fibrillation - therapy
Cardiovascular
Cardiovascular death
Female
Humans
Male
Observational Studies as Topic - methods
Randomized Controlled Trials as Topic - methods
Sex Characteristics
Stroke
Symptomatic
Treatment Outcome
Cardiovascular death
Stroke
Asymptomatic
Symptomatic
Atrial fibrillation
ISSN:0167-5273, 1874-1754, 1874-1754
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Popis
Shrnutí:Up to 40% of atrial fibrillation (AF) patients are asymptomatic. Despite this, scarce data are available about asymptomatic AF, with regard to its clinical profile and relationship to cerebrovascular and cardiovascular risks. Our objective was to conduct a systematic review and meta-analysis was to study the relationship between age and gender with asymptomatic AF and to establish whether patients with asymptomatic AF have a higher risk of death (all-cause and cardiovascular) and stroke/systemic thromboembolism, when compared to symptomatic AF patients. After a comprehensive search, 6 studies (2 randomized clinical trials and 4 observational studies) were entered in the meta-analysis. Despite significant heterogeneity, our data show that the prevalence of females amongst asymptomatic AF group was significantly less compared to the symptomatic AF group (RR, 0.57; 95% CI: 0.52–0.64). No difference in age between asymptomatic and symptomatic AF patients (P=0.72) was seen. No differences were found in all-cause death between patients with asymptomatic and symptomatic AF (RR, 1.38; 95% CI: 0.82–2.17), nor in cardiovascular death (RR, 0.85; 95% CI: 0.53–1.36) or stroke/thromboembolism (RR, 1.72 95% CI: 0.59–5.08). Asymptomatic AF is more associated with male sex, irrespective of age. Both general and cardiovascular death risks as well as thromboembolic risk do not seem to be affected by the asymptomatic clinical status. Symptomatic status should not determine our approach to stroke prevention and other cardiovascular prevention therapies, amongst patients with AF. •Asymptomatic atrial fibrillation (AF) is more associated with male sex, irrespective of age.•Asymptomatic clinical status doesn't seem to affect death risk as well as thromboembolic risk.•Clinical status shouldn't determine our approach to pharmacological prevention strategies.
Bibliografia:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-Review-3
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ISSN:0167-5273
1874-1754
1874-1754
DOI:10.1016/j.ijcard.2015.05.011