AI Article Synopsis
- Atrial fibrillation (AF) increases the risk of death in heart failure patients, especially those with ischaemic heart disease, as shown in a study of 3,587 patients over eight years.
- During the follow-up, mortality rates were higher for patients with AF compared to those without, with notable differences observed at both four and eight years.
- The study highlights that AF’s impact on long-term mortality is significant primarily in patients with ischaemic heart disease, potentially clarifying the mixed outcomes found in previous research on AF and heart failure.
Article Abstract
Aims: Atrial fibrillation (AF) is a risk factor for death in patients with a myocardial infarction, but highly variable results are reported in patients with heart failure. We studied the prognostic impact of AF in heart failure patients with and without ischaemic heart disease.
Methods And Results: During a period of 2 years, 3587 patients admitted to hospital because of heart failure were included in this study. All patients were examined by echocardiography and the presence of AF was recorded. Follow-up was available for 8 years. Twenty four percent of those discharged alive from hospital had AF. After 4 and 8 years of follow-up, mortality was higher in patients with AF than in patients without, 56 vs. 52% and 77 vs. 73%, respectively. Cox multivariable regression analysis showed a small but significant importance of AF for long-term mortality [hazard ratio (HR) 1.12, 95% confidence limits (CI), 1.02-1.23, P=0.018]. There was a significant interaction between the importance of AF and the presence of ischaemic heart disease (P=0.034). In patients with AF at the time of discharge and ischaemic heart disease, HR was 1.25 (95% CI: 1.09-1.42) and P<0.001; in patients with AF at discharge and without ischaemic heart disease, HR was 1.01 (95% CI: 0.88-1.16) and P=0.88.
Conclusion: AF is associated with increased risk of death only in patients with ischaemic heart disease. This finding may explain the variable results of studies of the prognosis associated with AF in heart failure.
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| http://dx.doi.org/10.1093/eurheartj/ehl359 | DOI Listing |
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