{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:06:04Z","timestamp":1790139964362,"version":"4.0.1"},"reference-count":34,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Daiichi-Sankyo","id":[{"id":"https:\/\/ror.org\/027y26122","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/027y26122","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Atrial fibrillation (AF) represents the most common sustained cardiac arrhythmia, and its incidence rises markedly with advancing age. The relative prognostic impact of age compared with AF type remains uncertain. This study assessed the association between age, AF type, and clinical outcomes in a large real-world AF cohort. Methods: This study was based on data from the prospective, observational, multicentre REGUEIFA registry, which includes consecutive patients with AF treated at eight hospitals in northwestern Spain. Patients were stratified by age and AF type. Baseline characteristics, comorbidities, treatments, and risk scores were collected. Patients were followed for at least 2 years, and outcomes included all-cause mortality, heart failure (HF) worsening, stroke, and a composite endpoint. Results: A total of 997 patients were included. Increasing age was associated with a worse clinical profile, with higher comorbidity burden and increased thromboembolic and bleeding risk. During follow-up, adverse events increased stepwise with age, including mortality, HF worsening, and the composite endpoint. AF type was not independently associated with outcomes after multivariable adjustment. Rhythm-control strategy was independently associated with a lower risk of the composite endpoint. Age remained an independent predictor of all outcomes. Risk of the composite endpoint increased across age groups (HR 2.01 for 75\u201384 years; 2.34 for 85\u201389 years; 6.50 for \u226590 years vs. &lt;75 years). Each additional year of age was associated with a 9% higher mortality risk (HR 1.09; 95% CI 1.06\u20131.13). Conclusions: In this prospective real-world cohort of patients with AF, age was the strongest and most consistent predictor of adverse clinical outcomes, whereas AF type lost prognostic significance after adjustment. These findings support age and overall clinical burden as key determinants of prognosis, favouring a patient-centred approach over AF subtype classification.<\/jats:p>","DOI":"10.3390\/jcm15187295","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:09:35Z","timestamp":1790075375000},"page":"7295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes According to Age and Atrial Fibrillation Type: Insights from the Multicentre REGUEIFA Registry"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6478-262X","authenticated-orcid":false,"given":"Alejandro Manuel","family":"L\u00f3pez-Pena","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain"},{"name":"CardioHULA Research Group, Fundaci\u00f3n Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela FIDIS, 27003 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Elices-Teja","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain"},{"name":"CardioHULA Research Group, Fundaci\u00f3n Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela FIDIS, 27003 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Dur\u00e1n-Bob\u00edn","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain"},{"name":"CardioHULA Research Group, Fundaci\u00f3n Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela FIDIS, 27003 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4065-221X","authenticated-orcid":false,"given":"Laila","family":"Gonz\u00e1lez-Melchor","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain"},{"name":"CardioHULA Research Group, Fundaci\u00f3n Instituto de Investigaci\u00f3n Sanitaria de Santiago de Compostela FIDIS, 27003 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-6555","authenticated-orcid":false,"given":"Mar\u00eda","family":"V\u00e1zquez-Caama\u00f1o","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital San Rafael, 15006 La Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliano","family":"Fern\u00e1ndez-Obanza","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital \u00c1lvaro Cunqueiro and Instituto de Investigaci\u00f3n Sanitaria Galicia Sur (IISGS), 36312 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Gonz\u00e1lez-Babarro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Montecelo, 36071 Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Cabanas-Grand\u00edo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital \u00c1lvaro Cunqueiro and Instituto de Investigaci\u00f3n Sanitaria Galicia Sur (IISGS), 36312 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Pi\u00f1eiro-Portela","sequence":"additional","affiliation":[{"name":"Cardiology Department, Complexo Hospitalario Universitario de A Coru\u00f1a, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2987-003X","authenticated-orcid":false,"given":"Oscar","family":"Prada-Delgado","sequence":"additional","affiliation":[{"name":"Cardiology Department, Complexo Hospitalario Universitario de A Coru\u00f1a, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4455-0704","authenticated-orcid":false,"given":"Mario","family":"Guti\u00e9rrez-Feijoo","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Ourense, 32005 Ourense, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evaristo","family":"Freire","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital de Ourense, 32005 Ourense, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"D\u00edaz-Castro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital \u00c1lvaro Cunqueiro and Instituto de Investigaci\u00f3n Sanitaria Galicia Sur (IISGS), 36312 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3087-2067","authenticated-orcid":false,"given":"Javier","family":"Mu\u00f1iz","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Cardiovascular, Departamento de Ciencias de la Salud and Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), Universidade da Coru\u00f1a, CIBERCV, 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Barge-Caballero","sequence":"additional","affiliation":[{"name":"Cardiology Department, Complexo Hospitalario Universitario de A Coru\u00f1a, Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a (INIBIC), 15006 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7903-9490","authenticated-orcid":false,"given":"Javier","family":"Garc\u00eda-Seara","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico de Santiago de Compostela, CIBERCV, 15706 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4483-9778","authenticated-orcid":false,"given":"Carlos","family":"Gonz\u00e1lez-Juanatey","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain"},{"name":"Nursing School of Santiago de Compostela University (Campus Lugo), 2001 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Rienstra","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"i4482","DOI":"10.1136\/bmj.i4482","article-title":"Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: Systematic review and meta-analysis","volume":"354","author":"Odutayo","year":"2016","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/jama.1994.03510350050036","article-title":"Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study","volume":"271","author":"Benjamin","year":"1994","journal-title":"JAMA"},{"key":"ref_4","first-page":"259","article-title":"Prevalence of atrial fibrillation in Spain. OFRECE study results","volume":"67","author":"Lobos","year":"2014","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1001\/jama.285.18.2370","article-title":"Prevalence of diagnosed atrial fibrillation in adults: National implications for rhythm management and stroke prevention: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study","volume":"285","author":"Go","year":"2001","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1016\/j.jacc.2018.03.019","article-title":"Arrhythmias in patients \u2265 80 years of age: Pathophysiology, management, and outcomes","volume":"71","author":"Curtis","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2682","DOI":"10.1016\/j.ijcard.2012.06.118","article-title":"Pattern of atrial fibrillation and risk of outcomes: The Loire Valley Atrial Fibrillation Project","volume":"167","author":"Banerjee","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1093\/eurheartj\/ehw007","article-title":"The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding: A systematic review and meta-analysis","volume":"37","author":"Ganesan","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1093\/eurheartj\/ehn101","article-title":"Should we abandon the common practice of withholding oral anticoagulation in paroxysmal atrial fibrillation?","volume":"29","author":"Nieuwlaat","year":"2008","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Pena, A.M., Elices-Teja, J., Dur\u00e1n-Bob\u00edn, O., Gonz\u00e1lez-Melchor, L., V\u00e1zquez-Caama\u00f1o, M., Fern\u00e1ndez-Obanza, E., Gonz\u00e1lez-Babarro, E., Cabanas-Grand\u00edo, P., Pi\u00f1eiro-Portela, M., and Prada-Delgado, O. (2026). Age-Related Differences in the Clinical Profile and Management of Atrial Fibrillation: Results from the Multicentre REGUEIFA Registry. J. Clin. Med., 15.","DOI":"10.3390\/jcm15051955"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ahj.2023.03.015","article-title":"Association of CHA2DS2-VASc and HAS-BLED to frailty and frail outcomes: From the TREAT-AF study","volume":"261","author":"Pundi","year":"2023","journal-title":"Am. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ejim.2018.04.018","article-title":"Frailty and atrial fibrillation: A systematic review","volume":"56","author":"Villani","year":"2018","journal-title":"Eur. J. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e001257","DOI":"10.1136\/openhrt-2020-001257","article-title":"Polypharmacy and health outcomes in atrial fibrillation: A systematic review and meta-analysis","volume":"7","author":"Gallagher","year":"2020","journal-title":"Open Heart"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1161\/CIRCEP.112.970749","article-title":"Distribution and risk profile of paroxysmal, persistent, and permanent atrial fibrillation in routine clinical practice: Insight from the real-life global survey evaluating patients with atrial fibrillation international registry","volume":"5","author":"Chiang","year":"2012","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1093\/eurheartj\/ehi505","article-title":"Atrial fibrillation management: A prospective survey in ESC member countries: The Euro Heart Survey on Atrial Fibrillation","volume":"26","author":"Nieuwlaat","year":"2005","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e030499","DOI":"10.1161\/JAHA.123.030499","article-title":"Optimal medical therapy for heart failure and integrated care in patients with atrial fibrillation","volume":"14","author":"Bonini","year":"2025","journal-title":"J. Am. Heart Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1161\/01.CIR.0000072767.89944.6E","article-title":"Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality","volume":"107","author":"Wang","year":"2003","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1161\/CIRCULATIONAHA.119.040267","article-title":"Searching for atrial fibrillation poststroke: A white paper","volume":"140","author":"Schnabel","year":"2019","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.rccl.2020.10.015","article-title":"Dise\u00f1o y caracter\u00edsticas basales del estudio REGUEIFA (Registro Gallego Interc\u00e9ntrico de Fibrilaci\u00f3n Auricular)","volume":"56","author":"Seara","year":"2021","journal-title":"CardioClinics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jacep.2015.02.019","article-title":"Age-related differences in patients with atrial fibrillation in Europe","volume":"1","author":"Fumagalli","year":"2015","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1007\/s00380-023-02343-9","article-title":"Characteristics and outcomes in elderly patients with non-valvular atrial fibrillation","volume":"39","author":"Kodani","year":"2024","journal-title":"Heart Vessel."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"131445","DOI":"10.1016\/j.ijcard.2023.131445","article-title":"Aging and atrial fibrillation: A vicious circle","volume":"395","author":"Gao","year":"2024","journal-title":"Int. J. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1093\/europace\/euz292","article-title":"The association between patterns of atrial fibrillation, anticoagulation, and cardiovascular events","volume":"22","author":"Atar","year":"2020","journal-title":"Europace"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1093\/eurheartj\/ehn599","article-title":"Stroke in paroxysmal atrial fibrillation","volume":"31","author":"Friberg","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1365-2796.2007.01909.x","article-title":"Stroke event rates in anticoagulated patients with paroxysmal atrial fibrillation","volume":"264","author":"Lip","year":"2008","journal-title":"J. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"euad143","DOI":"10.1093\/europace\/euad143","article-title":"Risk of myocardial infarction and ischemic stroke in individuals with first-diagnosed paroxysmal vs. non-paroxysmal atrial fibrillation under anticoagulation","volume":"25","author":"Ntaios","year":"2023","journal-title":"Europace"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3354","DOI":"10.1161\/STROKEAHA.115.010947","article-title":"Fushimi AF Registry","volume":"46","author":"Takabayashi","year":"2015","journal-title":"Stroke"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"106774","DOI":"10.1016\/j.ejim.2026.106774","article-title":"Major adverse cardiovascular and bleeding outcomes in paroxysmal vs. non-paroxysmal atrial fibrillation","volume":"148","author":"Ntaios","year":"2026","journal-title":"Eur. J. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1001\/jamacardio.2018.1176","article-title":"Association of burden of atrial fibrillation with risk of ischemic stroke","volume":"3","author":"Go","year":"2018","journal-title":"JAMA Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.amjcard.2024.06.020","article-title":"Association of regression from sustained to paroxysmal atrial fibrillation with clinical outcomes","volume":"227","author":"Esato","year":"2024","journal-title":"Am. J. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"58","DOI":"10.2174\/1871529X17666170104120746","article-title":"Biomarker assays for personalised stroke risk assessment in atrial fibrillation","volume":"17","author":"Hall","year":"2017","journal-title":"Cardiovasc. Hematol. Disord. Drug Targets"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1093\/eurheartj\/ehw054","article-title":"The ABC stroke risk score","volume":"37","author":"Hijazi","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e310724232529","DOI":"10.2174\/011573403X293703240715104503","article-title":"A systematic review on the effectiveness of machine learning in the detection of atrial fibrillation","volume":"21","author":"Abdulraheem","year":"2025","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_34","first-page":"2441","article-title":"Catheter Ablation for Atrial Fibrillation in Elderly Patients: An Updated Meta-analysis of Comparative Studies","volume":"40","author":"Boehmer","year":"2024","journal-title":"Can. J. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:37:31Z","timestamp":1790138251000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":34,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187295"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187295","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]}}}