Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease

Objective: To estimate the incidence, prevalence, and correlates of atrial fibrillation (AF) in a global population with rheumatic heart disease (RHD). Methods: Bibliographic databases were searched to identify all published studies providing data on AF in patients with RHD. Random-effects meta-anal...

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Main Authors: Jean Jacques Noubiap, Ulrich Flore Nyaga, Aude Laetitia Ndoadoumgue, Jan René Nkeck, Anderson Ngouo, Jean Joel Bigna
Format: Article
Language:English
Published: Ubiquity Press 2020-05-01
Series:Global Heart
Subjects:
Online Access:https://globalheartjournal.com/articles/807
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spelling doaj-d5770fe7c1ef489e852ef5f70d3f01e62020-11-25T02:23:51ZengUbiquity PressGlobal Heart2211-81792020-05-0115110.5334/gh.807768Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart DiseaseJean Jacques Noubiap0Ulrich Flore Nyaga1Aude Laetitia Ndoadoumgue2Jan René Nkeck3Anderson Ngouo4Jean Joel Bigna5Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, AdelaideDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, YaoundéSchool of Health and Related Research, The University of Sheffield, SheffieldDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, YaoundéDepartment of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, YaoundéDepartment of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, CM; Faculty of Medicine, University of Paris Sud XI, Le Kremlin-BicêtreObjective: To estimate the incidence, prevalence, and correlates of atrial fibrillation (AF) in a global population with rheumatic heart disease (RHD). Methods: Bibliographic databases were searched to identify all published studies providing data on AF in patients with RHD. Random-effects meta-analysis method was used to pool estimates. Results: Eighty-three studies were included, reporting data from 75,637 participants with RHD in 42 countries. The global prevalence of AF in RHD was 32.8% (range: 4.3%–79.9%). It was higher in severe valvular disease (30.8% vs 20.7%, p = 0.009), in severe mitral valve disease compared to severe aortic disease (30.4% vs 6.3%, p = 0.038). The global cumulative incidence of AF in patients with RHD was 4.8%, 11.4%, 13.2%, and 30.8% at 1, 2, 5, and 10 years of follow-up, respectively. From comparison between patients with and without AF, AF was associated with increased age (mean difference [MD]: 9.5 years; 95% CI: 7.8–1.3), advanced heart failure (odds ratio [OR]: 4.4; 95% CI 2.1–9.3), tricuspid valve involvement (OR: 4.0; 95% CI: 3.0–5.3), history of thromboembolism (OR: 6.2; 95% CI: 3.4–11.4), highly sensitive C-reactive protein (MD: 5.5 mg/dL; 95% CI: 1.2–9.8), systolic pulmonary arterial pressure (MD: 3.6 mmHg; 95% CI: 0.8–6.3), right atrium pressure (MD: 1.5 mmHg; 95% CI: 1.0–2.0), and left atrium diameter (MD: 8.1 mm; 95% CI: 5.5–10.7). Conclusions: About one-third of patients with RHD have AF, with an incidence which almost triples every five years after diagnosis. Factors associated with AF include age, advanced heart failure, thromboembolism, and few cardiac hemodynamics parameters.https://globalheartjournal.com/articles/807atrial fibrillationrheumatic heart diseaseprevalenceincidencerisk factors
collection DOAJ
language English
format Article
sources DOAJ
author Jean Jacques Noubiap
Ulrich Flore Nyaga
Aude Laetitia Ndoadoumgue
Jan René Nkeck
Anderson Ngouo
Jean Joel Bigna
spellingShingle Jean Jacques Noubiap
Ulrich Flore Nyaga
Aude Laetitia Ndoadoumgue
Jan René Nkeck
Anderson Ngouo
Jean Joel Bigna
Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease
Global Heart
atrial fibrillation
rheumatic heart disease
prevalence
incidence
risk factors
author_facet Jean Jacques Noubiap
Ulrich Flore Nyaga
Aude Laetitia Ndoadoumgue
Jan René Nkeck
Anderson Ngouo
Jean Joel Bigna
author_sort Jean Jacques Noubiap
title Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease
title_short Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease
title_full Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease
title_fullStr Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease
title_full_unstemmed Meta-Analysis of the Incidence, Prevalence, and Correlates of Atrial Fibrillation in Rheumatic Heart Disease
title_sort meta-analysis of the incidence, prevalence, and correlates of atrial fibrillation in rheumatic heart disease
publisher Ubiquity Press
series Global Heart
issn 2211-8179
publishDate 2020-05-01
description Objective: To estimate the incidence, prevalence, and correlates of atrial fibrillation (AF) in a global population with rheumatic heart disease (RHD). Methods: Bibliographic databases were searched to identify all published studies providing data on AF in patients with RHD. Random-effects meta-analysis method was used to pool estimates. Results: Eighty-three studies were included, reporting data from 75,637 participants with RHD in 42 countries. The global prevalence of AF in RHD was 32.8% (range: 4.3%–79.9%). It was higher in severe valvular disease (30.8% vs 20.7%, p = 0.009), in severe mitral valve disease compared to severe aortic disease (30.4% vs 6.3%, p = 0.038). The global cumulative incidence of AF in patients with RHD was 4.8%, 11.4%, 13.2%, and 30.8% at 1, 2, 5, and 10 years of follow-up, respectively. From comparison between patients with and without AF, AF was associated with increased age (mean difference [MD]: 9.5 years; 95% CI: 7.8–1.3), advanced heart failure (odds ratio [OR]: 4.4; 95% CI 2.1–9.3), tricuspid valve involvement (OR: 4.0; 95% CI: 3.0–5.3), history of thromboembolism (OR: 6.2; 95% CI: 3.4–11.4), highly sensitive C-reactive protein (MD: 5.5 mg/dL; 95% CI: 1.2–9.8), systolic pulmonary arterial pressure (MD: 3.6 mmHg; 95% CI: 0.8–6.3), right atrium pressure (MD: 1.5 mmHg; 95% CI: 1.0–2.0), and left atrium diameter (MD: 8.1 mm; 95% CI: 5.5–10.7). Conclusions: About one-third of patients with RHD have AF, with an incidence which almost triples every five years after diagnosis. Factors associated with AF include age, advanced heart failure, thromboembolism, and few cardiac hemodynamics parameters.
topic atrial fibrillation
rheumatic heart disease
prevalence
incidence
risk factors
url https://globalheartjournal.com/articles/807
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