Association of iron deficiency anemia with the development of paroxysms of atrial fibrillation within a year after pharmacological cardioversion with amiodarone

Abstract

BACKGROUND: Anemia is a common problem with atrial fibrillation. There is a limited number of studies examining the role of iron deficiency anemia in the course of atrial fibrillation.

AIM: To evaluate the association of iron deficiency anemia with the development of recurrent atrial fibrillation within 12 months in patients after pharmacological cardioversion with amiodarone.

MATERIAL AND METHODS: The study included 198 patients over 18 years of age [120 (60.6%) men and 78 (39.4%) women, median age 71 (63.2; 77) years] with paroxysmal non-valvular atrial fibrillation and duration of paroxysm <48 h, after successful pharmacological cardioversion with amiodarone. The group with anemia included 99 patients (all had iron deficiency anemia), the group without anemia included 99 people. Patients with anemia were older; the groups were comparable in other main indicators. The development of recurrent atrial fibrillation over 1 year of follow-up was assessed by the Kaplan–Meier method and the Cox proportional hazards model. Differences were considered statistically significant at a p value <0.05.

RESULTS: In the iron deficiency anemia group, symptomatic relapses of atrial fibrillation developed in 40.4% of patients during 1 year of observation; in the group without anemia — in 25.3% of patients (p=0.003). Kaplan–Meier analysis showed that iron deficiency anemia is associated with an increased risk of developing recurrent atrial fibrillation within 1 year after pharmacological cardioversion with amiodarone, relative risk 1.87 (p=0.014). Comparison of the risks associated with iron deficiency anemia and iron deficiency (regardless of the presence of anemia) showed a greater risk of recurrent atrial fibrillation associated with iron deficiency than with anemia (for interaction p=0.014).

CONCLUSION: A comparison of the risks of developing recurrent atrial fibrillation in patients with iron deficiency itself and in patients with iron deficiency anemia showed a greater influence on the prognosis of recurrent atrial fibrillation by the presence of iron deficiency.

Keywords

atrial fibrillation / anemia / iron deficiency / pharmacological cardioversion / repeated paroxysms

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