Meta-analysis of Atrial Fibrillation in Patients With Various Cardiomyopathies - 18/05/19

Doi : 10.1016/j.amjcard.2019.04.028

Jean Jacques Noubiap, MD ^a,^⁎ , Jean Joel Bigna, MD ^b, Valirie N. Agbor, MD ^c,^d, Clarence Mbanga, MD ^e, Aude Laetitia Ndoadoumgue, MD ^f, Jan René Nkeck, MD ^e, Arnaud Kamguia, MD ^e, Ulrich Flore Nyaga, MD ^e, Ntobeko A.B. Ntusi, MD ^a,^g,^h
^a Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
^b Faculty of Medicine, University of Paris Sud XI, Le Kremlin-Bicêtre, France
^c Ibal Sub-Divisional Hospital, Oku, Northwest Region, Cameroon
^d Department of Clinical Research, Health Education and Research Organization (HERO), Buea, Cameroon
^e Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
^f School of Health and Related Research, The University of Sheffield, Sheffield, United Kingdom
^g Cape Universities Body Imaging Center, University of Cape Town, Cape Town, South Africa
^h Department of Medicine, Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa

^⁎Corresponding author: Tel: +27738036352.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 18 May 2019
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Résumé

Patients with cardiomyopathy are at risk of developing atrial fibrillation (AF) which is a strong risk factor for thromboembolic events, progression to heart failure, and mortality or heart transplantation. This systematic review and meta-analysis sought to estimate the prevalence of AF in a global population with cardiomyopathy. PubMed and EMBASE were searched from inception until June 30, 2017 for published articles on AF and major cardiomyopathies without language restrictions. Eligible papers were independently assessed for methodological qualities. The prevalence of AF in patients with cardiomyopathy was estimated using a random-effect model. The chi-square test on Cochrane's Q statistics was used to evaluate heterogeneity across studies. In total 220 full texts representing a population of 118,668 participants were included in the meta-analysis. The ages of the participants ranged from a median of 31 to 72 years. The proportion of males ranged from 3% to 97%. Considering only cardiomyopathies with more than one contributing study, the prevalence of AF was highest in participants with dilated (24% [95% confidence interval: 21 to 28]), ischemic (20% [8 to 35]), and hypertrophic (19% [17 to 21]) cardiomyopathies, and lowest in patients with peripartum cardiomyopathies (5% [1 to 11]). In conclusion, with the exception of peripartum cardiomyopathy, an average of 1 to 2 in every 10 patients with a cardiomyopathy had AF, with no gender difference. Future guidelines need to take into consideration the management of AF in all the forms of cardiomyopathy.

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