Factors associated with the primary composite endpoint
Table 2 summarizes the association between the clinical variables and
the primary composite endpoint. In the univariate Cox regression hazard
model, older age, persistent AF, hypertension, diabetes, heart failure,
old myocardial infarction, nonischemic myocardiopathy, higher
CHADS2 score, higher
CHA2DS2-VASc score, higher HAS-BLED
score, lower LVEF, larger LAD, antiplatelet drug use, warfarin use
compared with DOAC use, lower hemoglobin level, continuation of OAC use
during the follow-up period, AAD use at the end of the follow-up, and
late recurrence of AF were significantly associated with the occurrence
of the primary composite endpoint.
The multivariate analysis revealed that older age (hazard ratio [HR]
1.05; 95% confidence interval [CI] 1.03–1.07; P <0.001), hypertension (HR 1.58; 95% CI 1.04–2.42; P = 0.034),
heart failure (HR 1.87; 95% CI 1.24–2.83; P = 0.003), old
myocardial infarction (HR 4.25; 95% CI 2.44–7.41; P <0.001), nonischemic cardiomyopathy (HR 2.68; 95% CI 1.54–4.67;P = 0.001), and larger LAD (HR 1.18 per 5-mm increase; 95% CI,
1.02–1.36; P = 0.027) were independently associated with the
incidence of the primary composite endpoint after catheter ablation.
Conversely, freedom from AF recurrence was independently associated with
a lower risk of the primary composite endpoint (HR 0.57; 95% CI
0.39–0.83; P = 0.003).
We explored the association between freedom from AF recurrence and each
component of the primary composite endpoint without adjusting for
multiple testing. Freedom from AF was significantly associated with a
lower risk of ischemic stroke/TIA (HR 0.43; 95% CI 0.19–0.94; P= 0.035) and hospitalization for heart failure (HR 0.21; 95% CI
0.083–0.54; P = 0.001).