BACKGROUND: The incidence of atrial fibrillation (AF) in younger patients has increased in recent years, but there are limited data. OBJECTIVE: This study aims to evaluate the clinical characteristics and risk factors for ischemic stroke (IS) in hospitalized young patients with AF. METHODS: We evaluated consecutive patients with AF aged 18-50 years hospitalized in a large tertiary medical center (2014-2023). Cox regression was used to analyze risk factors for major adverse cardiac and cerebrovascular events (MACE) and new-onset IS. Propensity score matching was employed to analyze the impact of catheter ablation (CA) on the occurrence of MACE with Kaplan-Meier survival curves. RESULTS: The final cohort included 1358 patients with a median age of 45 (interquartile range [IQR], 40.8-48) years, 72.8% were men and 70.4% presented with comorbidities. During 4.5 (IQR, 2.7-7.2) years follow-up, 238 patients developed MACE, among which heart failure episodes had the highest incidence. CA can reduce the risk of MACE (hazard ratio [HR], 0.494; P = .002), and the occurrence of MACE is associated with CHA(2)DS(2)-VA scores in young patients with AF. Prior IS (HR, 10.412; P < .001) and antiplatelet therapy (HR, 3.447; P = .001) were independent risk factors for new-onset IS, whereas left ventricular ejection fraction >0.5 (HR, 0.367; P = .013) was a protective factor. CONCLUSION: The findings show that patients with AF ≤50 years old have an unfavorable prognosis, and MACE primarily occurs in those with comorbidities. CA is associated with a reduced risk of MACE. Further prospective controlled studies are needed to provide greater attention and tailored management strategies for this growing population.
(8.0+极速模式)