Atrial fibrillation ups risk of death, stroke, heart failure in patients with peripheral arterial disease

Atrial fibrillation (AF) predicts mortality, stroke, and heart failure in patients with peripheral arterial disease (PAD), reveals a recent study.

This finding stresses the need for proactive surveillance and holistic management of these individuals, according to the researchers.

This retrospective study used The Health Improvement Network database, which contains prospectively collected data from primary care practices, to examine the impact of AF on patients with PAD. The researchers identified individuals with newly diagnosed PAD between 8 January 1995 and 5 January 2017 and obtained relevant demographic data, clinical history, and medications.

Using propensity score matching, 5,685 patients in the dataset with PAD and baseline AF (case) were matched to those without AF (control) but otherwise similar characteristics. The researchers performed Cox regression analysis and calculated hazard ratios (HRs) for the outcomes of death, stroke, ischaemic heart disease, heart failure, and major amputation.

AF prevalence in this cohort was 10.2 percent. Multivariable analysis revealed that AF independently contributed to mortality (HR, 1.18, 95 percent confidence interval [CI], 1.12–1.26; p<0.01), cerebrovascular events (HR, 1.35, 95 percent CI, 1.17–1.57; p<0.01), and heart failure (HR, 1.87, 95 percent CI, 1.62–2.15; p<0.01), but not to ischaemic heart disease or limb loss.

“The combination of PAD and AF is linked with high risk of mortality and stroke,” the researchers said.