Long-term changes in frailty and incident atrial fibrillation, heart failure, coronary heart disease, and stroke: A prospective follow-up study

IF 7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Heart rhythm Pub Date : 2025-12-01 Epub Date: 2025-01-09 DOI:10.1016/j.hrthm.2025.01.004

Lingli Cai MD , Ying Sun MD , Jingjing Zhu MPH , Bin Wang PhD , Xiao Tan PhD , Wentao Shi PhD , Dachun Xu MD, PhD , Yu Wang MD, PhD , Yingli Lu MD, PhD , Ningjian Wang MD, PhD

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Abstract

Background

People with frailty have increased prevalence and incidence of atrial fibrillation (AF).

Objective

The study aimed to further investigate the association of long-term changes in frailty with risk of new-onset AF. Its associations with heart failure (HF), coronary heart disease (CHD), and stroke were also evaluated as a secondary aim.

Methods

More than 50,000 participants from UK Biobank cohort were included, with frailty index (FI) data and free of AF, HF, CHD, or stroke in baseline and follow-up assessments. Frailty status of the participants was categorized into nonfrail, prefrail, and frail based on their FI scores. FI in baseline and follow-ups are used to calculate the trajectories of frailty (ΔFI).

Results

During a median of 5.1 years of follow-up from the final assessment, 1729 cases of AF were recorded. Frailty trajectory analysis showed that even a 0.01 point per year increase in ΔFI was associated with 14% (95% confidence interval [CI] 1.08–1.20) higher risk of AF, independent of baseline FI after adjusting for potential confounders. Compared with maintained nonfrail participants, those with sustained frail status had the highest risk of incident AF (hazard ratio [HR] 1.95, 1.61–2.36). The risk declined by 30% (95% CI 0.53–0.94) when frail participants regressed to nonfrail or prefrail status, compared with sustained frail participants. These associations were similar in HF and CHD however not significant in stroke.

Conclusion

In middle-aged and elderly individuals, frailty remission or nonfrailty maintenance was associated with lower risk of AF, HF, and CHD compared with persistent frailty, regardless of previous frailty status and established risk factors.

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虚弱和房颤、心力衰竭、冠心病和中风的长期变化：一项前瞻性随访研究

背景：体弱多病的人群心房颤动（AF）的患病率和发病率增加。目的：该研究旨在进一步研究衰弱的长期变化与新发房颤风险的关系。其与心力衰竭（HF）、冠心病（CHD）和脑卒中的关联也被作为次要目的进行评估。方法：来自UK Biobank队列的5万多名参与者，在基线和随访评估中具有虚弱指数（FI）数据，无房颤、心衰、冠心病或卒中。根据参与者的FI得分，将他们的虚弱状态分为非虚弱、虚弱前和虚弱。基线和随访中的FI用于计算衰弱的轨迹（ΔFI）。结果：在最终评估后平均5.1年的随访中，记录了1729例房颤。衰弱轨迹分析显示，在调整潜在混杂因素后，即使ΔFI增加0.01点/年，也与AF风险增加14% （95% CI 1.08-1.20）相关，独立于基线FI。与持续虚弱的参与者相比，持续虚弱的参与者发生AF的风险最高（HR 1.95, 1.61-2.36）。与持续虚弱的参与者相比，当虚弱的参与者回归到非虚弱或虚弱前状态时，风险下降了30% （95% CI 0.53-0.94）。这些关联在心衰和冠心病中相似，但在卒中中不显著。结论：在中老年个体中，与持续虚弱相比，虚弱缓解或非虚弱维持与AF、HF和CHD的风险降低相关，无论先前的虚弱状态和既定的危险因素如何。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.