ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025
Clinical complexity in patients with atrial fibrillation: exploring differential risk profiles from European and Asian cohorts.
Article in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Opportunistic and systematic screening for atrial fibrillation in adults aged ≥ 65 years in primary care: a systematic review of randomized and cluster randomized trials.BMC cardiovascular disorders · 2026Pooled it
- Bidirectional association between COPD and AF: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- Left atrial appendage closure in patients with atrial fibrillation: grey zones involving trials, meta-analysis, and decision-making.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 · 2026Article
- Liver disease in management and outcomes of European and Asian patients with atrial fibrillation: A report from two observational prospective registries.European journal of clinical investigation · 2026Observational
- Impact of Anaemia on Management and Outcomes in Patients With Atrial Fibrillation: Insights From European and Asian Cohorts.European journal of clinical investigation · 2026Article
- Cardiovascular-kidney-metabolic interplay in patients with atrial fibrillation receiving direct oral anticoagulants.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 · 2026Article
- Association between blood urea nitrogen-to-albumin ratio and mortality among atrial fibrillation patients admitted to the intensive care unit.BMC cardiovascular disorders · 2026Article
- Temporal trends and disparities in US mortality with co-listed atrial fibrillation and gastrointestinal bleeding-related mortality, 1999-2020.BMC cardiovascular disorders · 2026Article
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11 authors.
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Abstract
aimsClinical complexity (CC) in atrial fibrillation (AF) reflects overlapping risk factors that raise vulnerability to both thromboembolism and bleeding. Ethnic differences in the expression of CC remain poorly characterized. METHODS AND
resultsWe performed a post hoc analysis of the EORP-AF and APHRS-AF registries. CC was defined as a CHA₂DS₂-VASc score ≥2 plus ≥1 of: (i) age ≥75 and BMI <23 kg/m², (ii) chronic kidney disease, or (iii) prior major bleeding. Multivariable logistic regression identified predictors of CC, oral anticoagulant (OAC) use, and rhythm control. The primary outcome was a composite of all-cause death and major adverse cardiovascular events (MACE), defined as cardiovascular death, acute coronary syndromes, and thromboembolic events. Secondary outcomes included each individual component and major bleeding. Associations were assessed using Cox regression models. Among 14 055 patients, 2794 (19.9%) met CC criteria (mean age 77 ± 9 years; 46% female). Compared to Europeans, Asian patients with CC had a distinct clinical profile and were less likely to receive OAC (OR 0.75, 95% CI 0.57-1.01) or rhythm control (OR 0.53, 95% CI 0.41-0.69). CC was independently associated with increased risk of composite outcome (HR 1.55, 95% CI 1.35-1.77), all-cause death (HR 1.65, 95% CI 1.42-1.93), MACE (HR 1.50, 95% CI 1.26-1.80), cardiovascular death (HR 1.81, 95% CI 1.40-2.36), and major bleeding (HR 2.02, 95% CI 1.47-2.77). The excess risk of the composite outcome was greater in Asians (HR 2.28, 95% CI 1.57-3.32) than in Europeans (HR 1.51, 95% CI 1.31-1.75; P-interaction = 0.036).
conclusionAmong AF patients with CC, those enrolled in Asia exhibited marked differences in clinical profiles, management strategies, and outcomes, suggesting greater vulnerability to CC in the Asian population.
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