{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T13:05:09Z","timestamp":1793883909004,"version":"4.7.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The risk factor (RF) burden, clinical course, and long-term outcome among patients with atrial fibrillation (AF) aged &lt;65 years is unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Adult (n=67\u2005221; mean age, 72.4\u00b112.3 years; and 45% women) patients with AF evaluated at the University of Pittsburgh Medical Center between January 2010 and December 2019 were studied. Hospital system\u2013wide electronic health records and administrative data were utilized to ascertain RFs, comorbidities, and subsequent hospitalization and cardiac interventions. The association of AF with all-cause mortality among those aged &lt;65 years was analyzed using an internal contemporary cohort of patients without AF (n=918\u2005073).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Nearly one-quarter (n=17\u2005335) of the cohort was aged &lt;65 years (32% women) with considerable cardiovascular RFs (current smoker, 16%; mean body mass index, 33.0\u00b18.3; hypertension, 55%; diabetes, 21%; heart failure, 20%; coronary artery disease, 19%; and prior ischemic stroke, 6%) and comorbidity burden (chronic obstructive pulmonary disease, 11%; obstructive sleep apnea, 18%; and chronic kidney disease, 1.3%). Over mean follow-up of &gt;5 years, 2084 (6.7%, &lt;50 years; 13%, 50\u201365 years) patients died. The proportion of patients with &gt;1 hospitalization for myocardial infarction, heart failure, and stroke was 1.3%, 4.8%, and 1.1% for those aged &lt;50 years and 2.2%, 7.4%, and 1.1% for the 50- to 65-year subgroup, respectively. Multiple cardiac and noncardiac RFs were associated with increased mortality in younger patients with AF with heart failure and hypertension demonstrating significant age-related interaction (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.007 and\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.013, respectively). Patients with AF aged &lt;65 years experienced significantly worse survival compared with comorbidity-adjusted patients without AF (men aged &lt;50 years and hazard ratio, 1.5 [95% CI, 1.24\u20131.79]; 50\u201365 years and hazard ratio, 1.3 [95% CI, 1.26\u20131.43]; women aged &lt;50 years and hazard ratio, 2.4 [95% CI, 1.82\u20133.16]; 50\u201365 years and hazard ratio, 1.7 [95% CI, 1.6\u20131.92]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Patients with AF aged &lt;65 years have significant comorbidity burden and considerable long-term mortality. They are also at a significantly increased risk of hospitalization for heart failure, stroke, and myocardial infarction. These patients warrant an aggressive focus on RF and comorbidity evaluation and management.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.123.012143","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T09:00:30Z","timestamp":1713776430000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Mortality, Hospitalization, and Cardiac Interventions in Patients With Atrial Fibrillation Aged &lt;65 Years"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-5977","authenticated-orcid":true,"given":"Aditya","family":"Bhonsale","sequence":"first","affiliation":[{"name":"Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6066-0121","authenticated-orcid":true,"given":"Jianhui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floyd","family":"Thoma","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Koscumb","sequence":"additional","affiliation":[{"name":"Clinical Analytics (S.K., O.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2550-9359","authenticated-orcid":true,"given":"Krishna","family":"Kancharla","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1577-6541","authenticated-orcid":true,"given":"Andrew","family":"Voigt","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-3604","authenticated-orcid":true,"given":"Jared","family":"Magnani","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5461-7247","authenticated-orcid":true,"given":"N.A.","family":"Estes","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4669-803X","authenticated-orcid":true,"given":"Samir","family":"Saba","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA."},{"name":"Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Marroquin","sequence":"additional","affiliation":[{"name":"Clinical Analytics (S.K., O.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5060-429X","authenticated-orcid":true,"given":"Suresh","family":"Mulukutla","sequence":"additional","affiliation":[{"name":"Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5815-370X","authenticated-orcid":true,"given":"Sandeep","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.063"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2017.154"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht483"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.11760"},{"key":"e_1_3_3_7_2","unstructured":"Actuarial life table. Office of the Chief Actuary Social Security Administration. Accessed February 11 2021. https:\/\/www.ssa.gov\/oact\/STATS\/table4c6.html"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2007.07.010"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.004903"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61774-8"},{"key":"e_1_3_3_11_2","first-page":"1","volume-title":"The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General","author":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health","year":"2014","unstructured":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention (US); 2014:1\u201310."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1169"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.0095"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4482"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.0810"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000748"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.002"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs071"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.123.012143","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T21:07:47Z","timestamp":1748552867000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.123.012143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1161\/CIRCEP.123.012143"],"URL":"https:\/\/doi.org\/10.1161\/circep.123.012143","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2023-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}