TY - JOUR
T1 - Does rhythm matter in Acute Heart Failure? an insight from the British Society for Heart Failure National Audit
AU - Anderson, Simon
AU - Shoaib, Ahmad
AU - Myint, Phyo Kyaw
AU - Cleland, John
AU - Hardman, Suzanna M.
AU - McDonagh, Theresa
AU - Dargie, Henry
AU - Keavney, Bernard
AU - Garratt, Clifford
AU - Mamas, Mamas
PY - 2019
Y1 - 2019
N2 - Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with acute Heart Failure (AHF). The presence of AF is associated with adverse prognosis in patients with chronic Heart Failure (CHF) but little is known about its impact in AHF.
Methods: Data was collected between April 2007 to March 2013 across 185 (>95%) hospitals in England & Wales for patients with a primary death or a discharge diagnosis of AHF. We investigated the association between the presence of AF and all-cause mortality during the index hospital admission, at 30 days and 1-year post-discharge.
Results: Of 96,593 patients admitted with AHF, 44,642 (46%) were in sinus rhythm (SR) and 51,951 (54%) in AF. Patients with AF were older (mean age 79.8 (79.7-80) versus 74.7 (74.5-74.7) years; p<0.001), than those in SR. In a multivariable analysis, AF was independently associated with mortality at all time points, in hospital (HR 1.15, 95% CI 1.09-1.21, p<0.0001), 30 days (HR 1.13, 95% CI 1.08-1.19, p<0.0001), and 1 year (HR 1.09, 95% CI 1.05-1.12, p<0.0001). In subgroup analyses, AF was independently associated with worse 30 days outcome irrespective of sex, ventricular phenotype and in all age groups except in those who aged between 55-74 years.
Conclusion: AF is independently associated with adverse prognosis in AHF during admission and up-to one-year post discharge. As the clinical burden of concomitant AF and AHF increases, further refinement in the detection, treatment and prevention of AF-related complications may have a role in improving patient outcomes.
AB - Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with acute Heart Failure (AHF). The presence of AF is associated with adverse prognosis in patients with chronic Heart Failure (CHF) but little is known about its impact in AHF.
Methods: Data was collected between April 2007 to March 2013 across 185 (>95%) hospitals in England & Wales for patients with a primary death or a discharge diagnosis of AHF. We investigated the association between the presence of AF and all-cause mortality during the index hospital admission, at 30 days and 1-year post-discharge.
Results: Of 96,593 patients admitted with AHF, 44,642 (46%) were in sinus rhythm (SR) and 51,951 (54%) in AF. Patients with AF were older (mean age 79.8 (79.7-80) versus 74.7 (74.5-74.7) years; p<0.001), than those in SR. In a multivariable analysis, AF was independently associated with mortality at all time points, in hospital (HR 1.15, 95% CI 1.09-1.21, p<0.0001), 30 days (HR 1.13, 95% CI 1.08-1.19, p<0.0001), and 1 year (HR 1.09, 95% CI 1.05-1.12, p<0.0001). In subgroup analyses, AF was independently associated with worse 30 days outcome irrespective of sex, ventricular phenotype and in all age groups except in those who aged between 55-74 years.
Conclusion: AF is independently associated with adverse prognosis in AHF during admission and up-to one-year post discharge. As the clinical burden of concomitant AF and AHF increases, further refinement in the detection, treatment and prevention of AF-related complications may have a role in improving patient outcomes.
KW - Acute heart failure
KW - Atrial fibrillation
KW - Prognosis
KW - Mortality
U2 - 10.1007/s00392-019-01463-5
DO - 10.1007/s00392-019-01463-5
M3 - Article
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
ER -
