title: The change in the atrial fibrillation type as a prognosis marker in a community study: long-term data from AFBAR (Atrial Fibrillation in the BARbanza) study.
abstract: BACKGROUND
  The aim is to describe the prognosis role of the change in the atrial fibrillation (AF) type in an unselected population of patients with AF currently attending primary care in a single health-service area in Galicia, north-western Spain.
  
  
  METHODS
  AFBAR is a cohort study that was carried out by 35 primary care providers in 2008. Participants were followed up for a mean of 2.8 ± 0.7 years. 798 patients with the diagnosis of AF who presented at their clinics during a three-month period were recruited. Primary endpoint was mortality or hospital admission.
  
  
  RESULTS
  778 patients (413 male) were analyzed; mean age 74.8 years old. Hypertension was the most prevalent risk factor (76.5%). Permanent AF was diagnosed in 529 patients (68.0%). Change of AF status occurred in 76 patients (9.8%). During follow-up 52.1% of the patients underwent a primary endpoint and the overall survival was 83.4%. The following independent determinants of primary endpoint were identified: change in AF status (Hazard Ratio (HR) 1.41 (95%-confidence interval (CI) 1.04-1.92); p=0.026); previous heart failure (HR 1.28 (95%-CI 1.00-1.65); p=0.050); previous cardiovascular admission (HR 1.54 (95%-CI 1.16-2.03); p=0.002); stroke (HR 2.02 (95%-CI 1.35-3.03); p=0.001);ischemic heart disease (HR 1.28 (95%-CI 1.00-1.65); p=0.050); chronic obstructive pulmonary disease (HR 1.28 (95%-CI 1.00-1.64);p=0.042); anemia (HR 1.37 (95% CI 1.08-1.75); p=0.010); or AF-related complications (HR 1.45 (95%-CI 1.18-1.78); p<0.001).
  
  
  CONCLUSIONS
  The change in AF status showed to be an important prognosis marker for death or hospital admissions in a primary care cohort.
authors: Servizo de Cardioloxía, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Santiago de Compostela, Spain. Electronic address: rafavidal@hotmail.com.
authors: Rafael
authors: R
authors: Vidal-Perez
authors: Fernando
authors: F
authors: Otero-Raviña
authors: Manuel
authors: M
authors: Lado-López
authors: Victorino
authors: V
authors: Turrado-Turrado
authors: Esperanza
authors: E
authors: Rodríguez-Moldes
authors: José L
authors: JL
authors: Gómez-Vázquez
authors: Concepción
authors: C
authors: de Frutos-de Marcos
authors: Paula
authors: P
authors: de Blas-Abad
authors: Ricardo
authors: R
authors: Besada-Gesto
authors: José Ramón
authors: JR
authors: Gonzalez-Juanatey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: Atrial fibrillation; Primary care; Prognosis