title: Incidence and risk factors for atrial fibrillation in patients with newly diagnosed heart failure.
abstract: OBJECTIVE
  We aimed to identify the incidence and risk factors for first ever atrial fibrillation among patients with newly diagnosed heart failure following initial heart failure diagnosis.
  
  
  METHODS
  A heart failure inception cohort of patients aged 20-89 years without atrial fibrillation or cancer (N = 14 457) from 2000 to 2005 was identified from The Health Improvement Network primary care database in the United Kingdom and followed for a mean of 2.67 years. First ever cases of atrial fibrillation were identified and controls (N = 3000) were frequency matched to cases by age and sex. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using unconditional logistic regression.
  
  
  RESULTS
  One thousand four hundred and eighty-nine patients (10.3%) developed a first episode of atrial fibrillation: incidence rate 27.3/1000 person-years. A three-fold increased risk of atrial fibrillation was seen in the first 6 months after heart failure diagnosis, OR 3.62 (95% CI: 2.97-4.42) with the risk decreasing thereafter. Other risk factors were excessive alcohol consumption (OR 2.91, 1.60-5.30) and valvular heart disease (OR 1.98, 1.63-2.40) and use of oral steroids (OR 1.76, 95% CI: 1.40-2.22). Reduced risks of atrial fibrillation were found with use of statins (OR 0.65, 95% CI: 0.56-0.76) and β-blockers (OR 0.78, 95% CI: 0.67-0.91).
  
  
  CONCLUSIONS
  The incidence of first ever atrial fibrillation among newly diagnosed heart failure patients is high, especially in the first 6 months after diagnosis. This time relationship, together with the identified risk factors for atrial fibrillation, warrants consideration in the medical care of patients with heart failure.
authors.affiliation: aSpanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain bBayer Pharma AG, Epidemiology, Berlin, Germany.
authors.forename: Mar
authors.initials: M
authors.lastname: Martín-Pérez
authors.forename: Ana
authors.initials: A
authors.lastname: Ruigómez
authors.forename: Alexander
authors.initials: A
authors.lastname: Michel
authors.forename: Luis A
authors.initials: LA
authors.lastname: García Rodríguez
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care; D012307:Risk Factors; D017678:Sex Distribution; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors