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

Jean Jacques Noubiap; Ulrich Flore Nyaga; Aude Laetitia Ndoadoumgue; Jan René Nkeck; Anderson Ngouo; Jean Joel Bigna

doi:10.5334/gh.807

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

Volume 15 (2020): Issue 1

By: Jean Jacques Noubiap, Ulrich Flore Nyaga, Aude Laetitia Ndoadoumgue, Jan René Nkeck, Anderson Ngouo and Jean Joel Bigna

Open Access

|May 2020

Abstract

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.

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Articles in this issue

DOI: https://doi.org/10.5334/gh.807 | Journal eISSN: 2211-8179

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Language: English

Submitted on: Apr 16, 2020

Accepted on: Apr 16, 2020

Published on: May 18, 2020

Published by: Ubiquity Press

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

atrial fibrillation,

rheumatic heart disease,

prevalence,

incidence,

risk factors

© 2020 Jean Jacques Noubiap, Ulrich Flore Nyaga, Aude Laetitia Ndoadoumgue, Jan René Nkeck, Anderson Ngouo, Jean Joel Bigna, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 15 (2020): Issue 1