Clinical Characteristics and Risk Factors of Atrial Fibrillation in the Elderly

Abstract

Objective: To investigate the epidemiobgical characteristics of the elderly with atrial fibrillation (AF) in age, gender, the types of AF and relative causes. And To analyze the risk factors of persistent AF (PeAF), then use them to guide to prevent and treat for AF in the elderly.Methods: Collect the data of elderly patients with AF who were admitted to Liaoning People's Hospital from September 1, 2016 to September 30, 2017, and summarize the epidemiological characteristics of AF in the elderly. The risk factors for PeAF were analyzed by Spearman correlation analysis and mltivariate logistic regression analysis. Result: In accordance with the exclusion criteria,700 cases of elderly patients with AF were selected. The average age was 77.1±6.9 years old. There were 316 cases of male (45.1%) and 384 cases of female (54.9%).Age and GenderThe chosen patients were divided into three groups (65-74 years old, 75-84 years old, 85 years old and above). The number of AF was increased with age, and the largest proportion (49.9%) was 75-84 years old group. In every group, female was more than male (P>0.05).Relative CausesThe number of different causes of elderly AF: 481 cases of coronary heart disease(68.7%), 406 cases of hypertension (58.0%), 341 cases of heart failure (48.7%), 191 cases of diabetes (27.3%), 105 cases of valvular disease(15.0%), 25 cases of myocardiopathy (3.6%), 21 cases of sinus sick syndrome (3.0%), 20 cases of pulmonary heart disease(2.9%), 15 cases of lone AF (2.1%), 2 cases of congenital heart disease (0.3%). Then, 41 cases of rheumatic valvular disease, accounting for 39. 0% of the valvular disease, 5.9% of the total.Types of AFThere were 595 cases of nonvalvular AF, accounted for 85.0% of the total. The ratio of male to female was 1:1.2. In volvular AF, the ratio of male to female: was 1:1.3. In 314 cases of PAF, the ratio of male to female: was 1:1.3. In 386 cases of persistent AF, the ratio of male to female: was 1:1.1. Female was the most popular in all types (P>0.05).Clinical Data ComparisonThe age was older, the size of left atria diameter, CRP, uric acid and the incidence of heart failure, hypertension, cardiac valvular disease were higher while the LVEF was lower in PeAF group than in PAF group (P<0.05).Spearman Correlation AnalysisThere was age, heart failure, valvular disease, CRP, uric acid and left atrial diameter, which were positive correlations (P<0.05). LVEF was a negative correlation.Logistic Regression AnalysisThe risk factors for PeAF were analyzed by multivariate logistic regression analysis. It showed that left atria diameter and uric acid level were the independent risk factors of elderly PEAF.Conclusion:In the elderly, the number of AF cases increase with age. The group of 75-84 years old was the largest part. The number of older females was larger than male in all ages. It was important to pay more attention to old woman with AF.In the elderly, nonvalvular atrial fibrillation is popular. The top three causes of AF in the elderly were CHD, hypertension and heart failure. In the elderly, comorbidities were frequent, and the management was a major therapeutic objective.CRP, 1eft atria diameter were the independent risk factors for PeAF in the elderly.