Background: Risk factor management is crucial in the management of atrial fibrillation (AF). We investigated the association of changes in cardiovascular health (CVH) levels after AF diagnosis with incident cardiovascular events and mortality. Methods: From the Korea National Health Insurance Service database, 76,628 patients newly diagnosed with AF (2005–2015) with information on health examinations before and after AF diagnosis were assessed. According to the change in the 12-point CVH score before and after AF diagnosis, patients were stratified into four groups: consistently low (score 0–7 to 0–7), high-to-low (8–12 to 0–7), low-to-high (0–7 to 8–12), and consistently high (8–12 to 8–12) CVH levels. Risks of cardiovascular events and death were analyzed using weighted Cox regression models with inverse probability of treatment weighting (IPTW) for balance across study groups. Results: The mean age of study participants was 58.3 years, 50,285 were men (63.1%), and the mean follow-up was 5.5 years. After IPTW, low-to-high (hazard ratio [95% confidence interval], 0.83 [0.76–0.92]) and consistently high (0.80 [0.74–0.87]) CVH levels were associated with a lower risk of ischemic stroke than consistently low CVH. Low-to-high (0.66 [0.52–0.84]) and consistently high (0.52 [0.42–0.64]) CVH levels were associated with a lower risk of acute myocardial infarction. Maintaining high CVH was associated with reduced risks of heart failure hospitalization (0.85 [0.75–0.95]) and all-cause death (0.82 [0.77–0.88]), respectively, compared with consistently low CVH. Conclusions: Improving CVH levels and maintaining high CVH levels after AF diagnosis is associated with lower risks of subsequent cardiovascular events and mortality. Graphical abstract: [Figure not available: see fulltext.]
Bibliographical noteFunding Information:
This research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC19C0130). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine