The Cumulative Incidence of Stroke, Myocardial Infarction, Heart Failure and Sudden Cardiac Death in Patients with Atrial Fibrillation

Introduction: Atrial fibrillation is considered as a main cause of cardiovascular morbidity worldwide. A lot of progress was made to avoid the fatal complications of this type of cardiac arrhythmia. In Bosnia and Herzegovina there is no accurate published data on how much this arrhythmia is represented and how much is responsible for death and disability in our population. Research Objectives: The objective of our study is to determine the cardiac and cerebrovascular events (myocardial infarction, heart failure, stroke, sudden cardiac death) and their cumulative incidence during 11 years follow up period. Patients and methods: This study includes 2352 ambulant and hospitalized patients with atrial fibrillation (AF) who were enrolled during the follow up period. All patients underwent clinical evaluation in order to determine cardiac and cerebrovascular events (myocardial infarction, heart failure, stroke, sudden cardiac death) and their cumulative incidence. Results: The results of cumulative incidence for sudden cardiac death were 1.71%, for stroke 2.56%, for myocardial infarction 1.20% and for heart failure was 5.73%. In our study the age-adjusted incidence and prevalence of AF was slightly lower in women. The study shows that the risk of death was higher in females than in males with AF. Conclusion: Despite good progress in the management of patients with atrial fibrillation (AF), this arrhythmia remains one of the major causes of stroke, heart failure, sudden death. Effective treatment of patients with atrial fibrillation includes not only rate control, rhythm control, and prevention of stroke, but also management of cardiovascular risk factors and concomitant diseases.