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).