{"title":"无症状心房颤动的患病率及与无症状状态相关的危险因素：一项系统回顾和荟萃分析","authors":"Konstantinos Pamporis, Paschalis Karakasis, Marios Sagris, Panagiotis Theofilis, Nikias Milaras, Antonia Pantelidaki, Iordanis Mourouzis, Nikolaos Fragakis, Konstantinos Vlachos, Athanasios Kordalis, Dimitrios Tsiachris","doi":"10.1093/eurjpc/zwaf138","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Asymptomatic atrial fibrillation (AF) is frequent and associated with disease progression. This meta-analysis aimed to estimate the prevalence of asymptomatic AF and identify risk factors associated with asymptomatic status.</p><p><strong>Methods: </strong>MEDLINE(Pubmed), Scopus, Cochrane and ClinicalTrials.gov were searched until January 8, 2025. Double-independent study selection, data extraction and quality assessments were performed. Random-effects meta-analysis was used. Estimates are presented with the asymptomatic individuals in the nominator and the symptomatic patients in the denominator. The assessment of the prevalence of asymptomatic AF and the identification of risk factors associated with the asymptomatic status comprised the main endpoints.</p><p><strong>Results: </strong>Thirty-seven studies (224273 participants) were included. The prevalence of asymptomatic AF was 27% (95% confidence interval {CI}=[22%,33%]; I2=100%). Risk factors positively associated with the asymptomatic status were male sex (odds ratio {OR}=1.67, 95%CI=[1.48,1.89], p<0.001, I2=85%), diabetes mellitus (OR=1.19, 95%CI=[1.07,1.33], p=0.002, I2=87%), chronic kidney disease (OR=1.21, 95%CI=[1.08,1.36], p<0.001, I2=80%) and stroke/transient ischemic attack (OR=1.43, 95%CI=[1.18,1.73], p<0.001, I2=95%), while heart failure was negatively associated with asymptomatic AF (OR=0.71, 95%CI=[0.54,0.94], p=0.017, I2=97%). Asymptomatic status was also positively associated with permanent AF (OR=2.13, 95%CI=[1.28,3.55]; p=0.004; I2=98%) and negatively associated with catheter ablation (OR=0.63, 95%CI=[0.44,0.91]; p=0.012; I2=95%), beta-blockers (OR=0.90, 95%CI=[0.82,0.98]; p=0.018; I2=68%) and antiarrhythmics (OR=0.53, 95%CI=[0.35,0.79]; p=0.002; I2=95%).</p><p><strong>Conclusions: </strong>Asymptomatic AF was estimated around 27%, with large variability depending on the prevalence of risk factors associated with asymptomatic status. Asymptomatic individuals had distinct characteristics compared to symptomatic patients, regardless of symptoms' assessment methods and rhythm/rate control interventions. Our results could inform AF screening practices to target asymptomatic individuals.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4000,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of asymptomatic atrial fibrillation and risk factors associated with asymptomatic status: a systematic review and meta-analysis.\",\"authors\":\"Konstantinos Pamporis, Paschalis Karakasis, Marios Sagris, Panagiotis Theofilis, Nikias Milaras, Antonia Pantelidaki, Iordanis Mourouzis, Nikolaos Fragakis, Konstantinos Vlachos, Athanasios Kordalis, Dimitrios Tsiachris\",\"doi\":\"10.1093/eurjpc/zwaf138\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>Asymptomatic atrial fibrillation (AF) is frequent and associated with disease progression. This meta-analysis aimed to estimate the prevalence of asymptomatic AF and identify risk factors associated with asymptomatic status.</p><p><strong>Methods: </strong>MEDLINE(Pubmed), Scopus, Cochrane and ClinicalTrials.gov were searched until January 8, 2025. Double-independent study selection, data extraction and quality assessments were performed. Random-effects meta-analysis was used. Estimates are presented with the asymptomatic individuals in the nominator and the symptomatic patients in the denominator. The assessment of the prevalence of asymptomatic AF and the identification of risk factors associated with the asymptomatic status comprised the main endpoints.</p><p><strong>Results: </strong>Thirty-seven studies (224273 participants) were included. The prevalence of asymptomatic AF was 27% (95% confidence interval {CI}=[22%,33%]; I2=100%). Risk factors positively associated with the asymptomatic status were male sex (odds ratio {OR}=1.67, 95%CI=[1.48,1.89], p<0.001, I2=85%), diabetes mellitus (OR=1.19, 95%CI=[1.07,1.33], p=0.002, I2=87%), chronic kidney disease (OR=1.21, 95%CI=[1.08,1.36], p<0.001, I2=80%) and stroke/transient ischemic attack (OR=1.43, 95%CI=[1.18,1.73], p<0.001, I2=95%), while heart failure was negatively associated with asymptomatic AF (OR=0.71, 95%CI=[0.54,0.94], p=0.017, I2=97%). Asymptomatic status was also positively associated with permanent AF (OR=2.13, 95%CI=[1.28,3.55]; p=0.004; I2=98%) and negatively associated with catheter ablation (OR=0.63, 95%CI=[0.44,0.91]; p=0.012; I2=95%), beta-blockers (OR=0.90, 95%CI=[0.82,0.98]; p=0.018; I2=68%) and antiarrhythmics (OR=0.53, 95%CI=[0.35,0.79]; p=0.002; I2=95%).</p><p><strong>Conclusions: </strong>Asymptomatic AF was estimated around 27%, with large variability depending on the prevalence of risk factors associated with asymptomatic status. Asymptomatic individuals had distinct characteristics compared to symptomatic patients, regardless of symptoms' assessment methods and rhythm/rate control interventions. Our results could inform AF screening practices to target asymptomatic individuals.</p>\",\"PeriodicalId\":12051,\"journal\":{\"name\":\"European journal of preventive cardiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":8.4000,\"publicationDate\":\"2025-03-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of preventive cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/eurjpc/zwaf138\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of preventive cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/eurjpc/zwaf138","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Prevalence of asymptomatic atrial fibrillation and risk factors associated with asymptomatic status: a systematic review and meta-analysis.
Aim: Asymptomatic atrial fibrillation (AF) is frequent and associated with disease progression. This meta-analysis aimed to estimate the prevalence of asymptomatic AF and identify risk factors associated with asymptomatic status.
Methods: MEDLINE(Pubmed), Scopus, Cochrane and ClinicalTrials.gov were searched until January 8, 2025. Double-independent study selection, data extraction and quality assessments were performed. Random-effects meta-analysis was used. Estimates are presented with the asymptomatic individuals in the nominator and the symptomatic patients in the denominator. The assessment of the prevalence of asymptomatic AF and the identification of risk factors associated with the asymptomatic status comprised the main endpoints.
Results: Thirty-seven studies (224273 participants) were included. The prevalence of asymptomatic AF was 27% (95% confidence interval {CI}=[22%,33%]; I2=100%). Risk factors positively associated with the asymptomatic status were male sex (odds ratio {OR}=1.67, 95%CI=[1.48,1.89], p<0.001, I2=85%), diabetes mellitus (OR=1.19, 95%CI=[1.07,1.33], p=0.002, I2=87%), chronic kidney disease (OR=1.21, 95%CI=[1.08,1.36], p<0.001, I2=80%) and stroke/transient ischemic attack (OR=1.43, 95%CI=[1.18,1.73], p<0.001, I2=95%), while heart failure was negatively associated with asymptomatic AF (OR=0.71, 95%CI=[0.54,0.94], p=0.017, I2=97%). Asymptomatic status was also positively associated with permanent AF (OR=2.13, 95%CI=[1.28,3.55]; p=0.004; I2=98%) and negatively associated with catheter ablation (OR=0.63, 95%CI=[0.44,0.91]; p=0.012; I2=95%), beta-blockers (OR=0.90, 95%CI=[0.82,0.98]; p=0.018; I2=68%) and antiarrhythmics (OR=0.53, 95%CI=[0.35,0.79]; p=0.002; I2=95%).
Conclusions: Asymptomatic AF was estimated around 27%, with large variability depending on the prevalence of risk factors associated with asymptomatic status. Asymptomatic individuals had distinct characteristics compared to symptomatic patients, regardless of symptoms' assessment methods and rhythm/rate control interventions. Our results could inform AF screening practices to target asymptomatic individuals.
期刊介绍：
European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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