TY - JOUR
T1 - Atrial fibrillation, ischaemic heart disease, and the risk of death in patients with heart failure
AU - Pedersen, Ole Dyg
AU - Søndergaard, Peter
AU - Nielsen, Tonny
AU - Nielsen, Søren Junge
AU - Nielsen, Eric Steen
AU - Falstie-Jensen, Niels
AU - Nielsen, Ingolf
AU - Køber, Lars
AU - Burchardt, Hans
AU - Seibaek, Marie
AU - Torp-Pedersen, Christian
AU - DIAMOND study group investigators
N1 - Keywords: Aged; Aged, 80 and over; Atrial Fibrillation; Denmark; Female; Heart Failure; Hospital Mortality; Humans; Male; Middle Aged; Myocardial Ischemia; Prognosis; Regression Analysis; Risk Factors
PY - 2006
Y1 - 2006
N2 - 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.
AB - 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.
U2 - 10.1093/eurheartj/ehl359
DO - 10.1093/eurheartj/ehl359
M3 - Journal article
C2 - 17101637
VL - 27
SP - 2866
EP - 2870
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 23
ER -