DO AF SYMPTOMS MATTER
CCC ePoster Library. Harnett D. 10/26/19; 280515; 280
David Harnett
David Harnett
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Abstract
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BACKGROUND: Background/Introduction: Atrial Fibrillation (AF) is a common cardiac diagnosis following admission to hospital worldwide. AF in primary care often manifests with palpitations, dyspnea, chest pain, syncope or with no symptoms. The presenting symptoms for a diagnosis of AF leading to hospitalization have been poorly studied. It is likely that other correlated factors such as ischaemia, infection may predominate the cause for the admission diagnosis of AF. Purpose: We investigated the prevalence of the most common presenting symptoms leading to a diagnosis of AF and their association with comorbid diagnoses and long term mortality utilizing the large ACALM dataset from 2000-2014.

METHODS AND RESULTS: We identified 6979 unique patients presenting with either palpitations, dyspnea, chest pain or syncope followed by a diagnosis of AF admitted to multiple hospitals in England between 01/01/2000 and 30/6/2014 utilising the Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) 'big data' registry. Comorbid diagnoses and associations with these were analysed. Regression analysis was performed adjusting for Charlson scores to evaluate differences between age quartiles and naturalistic five-year mortality was reported. The characteristics of AF patients according to symptoms/comorbid diagnoses is shown in table 1. Patients presenting with palpitations and chest pain were younger and had lower Charlson score than patients with syncope and dyspnea (p < 0.01). Those who presented with chest pain had higher prevalence of a comorbid diagnosis of acute coronary syndrome and significantly improved mortality compared with other presentations. Cox regression model showed that a presenting symptom of palpitations (OR 1.31 95% C.I 1.10-1.56) and dyspnea (OR 1.30 95% C.I 1.11-1.52) were significant predicators of mortality.

CONCLUSION: The presenting symptoms of patients with a diagnosis of AF to hospital are varied and can have significant associations with comorbid diagnoses and mortality. AF is associated with increased mortality and should have comorbidities investigate and treated. The difference in morality based on presenting symptoms warrants further study.
BACKGROUND: Background/Introduction: Atrial Fibrillation (AF) is a common cardiac diagnosis following admission to hospital worldwide. AF in primary care often manifests with palpitations, dyspnea, chest pain, syncope or with no symptoms. The presenting symptoms for a diagnosis of AF leading to hospitalization have been poorly studied. It is likely that other correlated factors such as ischaemia, infection may predominate the cause for the admission diagnosis of AF. Purpose: We investigated the prevalence of the most common presenting symptoms leading to a diagnosis of AF and their association with comorbid diagnoses and long term mortality utilizing the large ACALM dataset from 2000-2014.

METHODS AND RESULTS: We identified 6979 unique patients presenting with either palpitations, dyspnea, chest pain or syncope followed by a diagnosis of AF admitted to multiple hospitals in England between 01/01/2000 and 30/6/2014 utilising the Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) 'big data' registry. Comorbid diagnoses and associations with these were analysed. Regression analysis was performed adjusting for Charlson scores to evaluate differences between age quartiles and naturalistic five-year mortality was reported. The characteristics of AF patients according to symptoms/comorbid diagnoses is shown in table 1. Patients presenting with palpitations and chest pain were younger and had lower Charlson score than patients with syncope and dyspnea (p < 0.01). Those who presented with chest pain had higher prevalence of a comorbid diagnosis of acute coronary syndrome and significantly improved mortality compared with other presentations. Cox regression model showed that a presenting symptom of palpitations (OR 1.31 95% C.I 1.10-1.56) and dyspnea (OR 1.30 95% C.I 1.11-1.52) were significant predicators of mortality.

CONCLUSION: The presenting symptoms of patients with a diagnosis of AF to hospital are varied and can have significant associations with comorbid diagnoses and mortality. AF is associated with increased mortality and should have comorbidities investigate and treated. The difference in morality based on presenting symptoms warrants further study.
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