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CLINICAL STATEMENTS AND GUIDELINES

Circulation. 2024;149:e1–e156. DOI: 10.1161/CIR.0000000000001193 January 2, 2024 e13

Joglar et al 2023 Guideline for the Diagnosis and Management of Atrial Fibrillation

Table 3.  Continued

(Continued )

Condition Study Type Effect on Risk of AF Summary Risk of Incident AF Effect of LRFM Diabetes Single study Diabetes: ↑ risk, population attributable fraction 3.1%5

Diabetes: ↑ risk, population attributable fraction ↑ over time 3.2%-5.9%26 ↑ Risk Optimal glycemic control preablation may ↓ AF recurrence postablation43

MA Diabetes: ↑ risk (HR, 1.27 [95% CI, 1.10-1.46])2 SR/MA Diabetes: ↑ risk (RR, 1.28, excluding large outlying study)44

Pre-diabetes: ↑ risk (RR, 1.20)44 Blood glucose; ↑ risk (RR per 20 mg/dL ↑, 1.11)44

Cardiovascular disease HF or CAD Single study HF or CAD: population attributable fraction 5.4%5 ↑ Risk N/A HF Single studies HF: ↑ risk but population attributable fraction ↓ d over time 7.8%-1.4%26

Bidirectional relation between AF and HF45 ↑ Risk N/A

MA History of HF: ↑ risk (HR, 2.02)2 MR Genetically predicted HF: ↑ risk (OR, 1.86)46

CAD Single study MI: Population attributable fraction 3.6%26 ↑ Risk N/A

MA History of MI: HR, 1.642 MR Genetically predicted CAD: OR, 1.1833

VHD Single studies Significant heart murmur: ↑ risk (HR, 2.38)47

Significant heart murmur (any diastolic and grade ≥3/6 systolic murmur): ↑ risk, population attributable fraction 21.9% ↓ d over time to 3.1%26 ↑ Risk N/A

MR Genetically predicted risk of AF in individuals of

European ancestry: associated with VHD with rheumatic fever (OR, 1.26) and nonrheumatic VHD (OR, 1.27)48

Cardiac surgery Single study Multicenter validated risk prediction model: ↑ risk AF after CABG49 ↑ Risk Prophylactic amiodarone, beta blockers: ↓↔ postop AF50–54

Posterior left pericardiotomy during CABG, aortic valve, ascending aortic aneurysm surgery: ↓ postop AF55,56

SR/MA Postop AF incidence: 23.7%-25.5%56 of cardiac surgery patients57

Other conditions CKD SR/MA CKD: ↑ risk (HR, 1.47)58 ↑↔ Risk N/A

MR Bidirectional relation between CKD and AF59

AF causal for CKD; CKD not causal for AF60

Obstructive sleep apnea SR/MA OSA: ↑ risk (OR, 1.71), with potential dose response relation by severity61 ↑ Risk Observational studies of SDB treatment: ↓ AF burden62–67

Small RCTs of SDB treatment: ↔68–70 MR Genetically predicted OSA: ↑ risk (OR, 1.21)71

Thyroid disease SR/MA Clinical hyperthyroidism: ↑ risk (RR, 2.35)72 ↑ Risk

MR Hyperthyroidism: ↑ risk (OR, 1.31)73

Sepsis Single study Severe sepsis: ↑ risk (OR, 6.82)74; Medicare population75 ↑ Risk N/A

SR/MA Sepsis severity: ↑ risk76

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