Clinical outcomes in recently diagnosed atrial fibrillation related to mitral stenosis compared to non-valvular atrial fibrillation.

BACKGROUND

Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and is associated with significant morbidity and mortality. Mitral stenosis (MS) is common in developing countries, affecting the younger population and posing a risk of atrial fibrillation.

OBJECTIVES

This study aims to delineate the clinical characteristics and poor outcomes in patients who have recent non-valvular AF (NVAF) compared with AF related to MS (MS-AF). Furthermore, it seeks to assess the healthcare resource utilization associated with the management of AF patients in the two groups.

PATIENTS AND METHODS

This is a prospective observational cohort conducted on 84 patients with recent AF. The patients were divided into two groups: the NVAF group (patients with no prosthetic valves or moderate/severe MS) and the MS-AF group (patients with AF in the presence of moderate/severe MS). The clinical characteristics, stroke risk, and anticoagulation regimens were assessed. AF-related outcomes (strokes, hospitalizations, major bleeding, and mortalities) were monitored and compared between the two groups.

RESULTS

The mean age of the studied AF patients was 49.80 ± 16.31 years, ranging from 25 to 89 years. Patients with MS-AF were significantly younger than patients with NVAF. Hypertension was the most prevalent risk factor associated with AF. Smoking, heart failure, and hypertension were more prevalent among patients with NVAF. The NVAF group received less anticoagulants than the MS-AF group. There were no statistically significant differences between the two groups regarding the overall incidence of death, stroke, myocardial infarction, TIA, or hospital admissions. In the overall studied group, all-cause mortality was higher among AF patients with a history of heart failure or stroke.

CONCLUSION

Patients with NVAF had a significantly greater incidence of cardiovascular disease risk factors. However, AF related to mitral stenosis was associated with comparable worse outcomes.