Evidence map›Paper›PMID 28617620›Full record

SynthesisEuropean journal of preventive cardiology2017

Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: A systematic review and meta-analysis.

Vidar Ruddox, Irene Sandven, John Munkhaugen, Julie Skattebu, Thor Edvardsen, Jan Erik Otterstad

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of preventive cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07008066 (Exercise-induced Cardioversion in Persistent Atrial Fibrillation), which is not on this map. Cited by 220 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
220citing papers in PubMed, 13 pooled it
13.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07008066 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Exercise-induced Cardioversion in Persistent Atrial Fibrillation (ExPAF): A Feasibility Pilot Study

TypeinterventionalSponsorUppsala UniversityRan2025 to 2026Enrolled60ConditionsAtrial Fibrillation (AF)ArmsBicycle ergometer excercise, Standard care with electrical cardioversion
3 · Its place in the literature

Who cites it

220 citing papers in PubMed, 13 syntheses or guidelines pooled it, 390 citations in OpenAlex.

  1. Pooled it
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  3. Guideline
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  8. The association of coagulation and atrial fibrillation: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Pooled it
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  11. A systematic review of randomized trials comparing double versus triple antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2020
    Pooled it
  12. Pooled it
  13. Prediction models for atrial fibrillation applicable in the community: a systematic review and meta-analysis.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2020
    Pooled it
  14. Incident heart failure in patients with screening-detected atrial fibrillation: a post hoc analysis of the STROKESTOP and STROKESTOP II studies.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
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160 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Vidar Ruddox1 Department of Cardiology, Vestfold Hospital Trust, Norway.
Irene Sandven2 Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway.
John Munkhaugen3 Department of Medicine, Drammen Hospital Trust, Norway.
Julie Skattebu1 Department of Cardiology, Vestfold Hospital Trust, Norway.
Thor Edvardsen4 Department of Cardiology, Oslo University Hospital, Norway.
Jan Erik Otterstad1 Department of Cardiology, Vestfold Hospital Trust, Norway.
Sykehuset i Vestfold · NOOslo University Hospital · NODrammen Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background In contemporary atrial fibrillation trials most deaths are cardiac related, whereas stroke and bleeding represent only a small subset of deaths. We aimed to evaluate the long-term risk of cardiac events and all-cause mortality in individuals with atrial fibrillation compared to no atrial fibrillation. Design A systematic review and meta-analysis of studies published between 1 January 2006 and 21 October 2016. Methods Four databases were searched. Studies had follow-up of at least 500 stable patients for either cardiac endpoints or all-cause mortality for 12 months or longer. Publication bias was evaluated and random effects models were used to synthesise the results. Heterogeneity between studies was examined by subgroup and meta-regression analyses. Results A total of 15 cohort studies was included. Analyses indicated that atrial fibrillation was associated with an increased risk of myocardial infarction (relative risk (RR) 1.54, 95% confidence interval (CI) 1.26-1.85), all-cause mortality (RR 1.95, 95% CI 1.50-2.54) and heart failure (RR 4.62, 95% CI 3.13-6.83). Coronary heart disease at baseline was associated with a reduced risk of myocardial infarction and explained 57% of the heterogeneity. A prospective cohort design accounted for 25% of all-cause mortality heterogeneity. Due to there being fewer than 10 studies, sources of heterogeneity were inconclusive for heart failure. Conclusions Atrial fibrillation seems to be associated with an increased risk of subsequent myocardial infarction in patients without coronary heart disease and an increased risk of, all-cause mortality and heart failure in patients with and without coronary heart disease.

Indexed as

AgedAtrial FibrillationCause of DeathCoronary DiseaseFemaleHeart FailureHumansIncidenceMaleMiddle AgedMyocardial InfarctionOdds RatioPrevalencePrognosisRisk AssessmentRisk FactorsAtrial fibrillationheart failuremortalitymyocardial infarction

Identifiers

PMID28617620
PMCPMC5598874
OpenAlexW2625125262

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.