Incidence and prediction of hospitalization for heart failure in patients with atrial fibrillation: the REFLEJA scale.

Autor: Torres Llergo J; Servicio de Cardiología, Hospital Universitario de Jaén, Jaén, Spain. Electronic address: javiertorresllergo@gmail.com., Carrillo Bailén M; Servicio de Cardiología, Hospital Universitario de Jaén, Jaén, Spain., Segura Aumente JM; Servicio de Cardiología, Hospital Universitario de Jaén, Jaén, Spain., Fernández Olmo MR; Servicio de Cardiología, Hospital Universitario de Jaén, Jaén, Spain., Puentes Chiachío M; Servicio de Cardiología, Hospital Universitario de Jaén, Jaén, Spain., Fernández Guerrero JC; Servicio de Cardiología, Hospital Universitario de Jaén, Jaén, Spain., Ruiz Ortiz M; Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2024 Sep; Vol. 77 (9), pp. 710-719. Date of Electronic Publication: 2024 Feb 19.
DOI: 10.1016/j.rec.2024.02.001
Abstrakt: Introduction and Objectives: Hospitalization for heart failure (HHF) is common in patients with atrial fibrillation (AF) and is associated with increased mortality. The aims of this study were to determine the incidence of HHF, identify the clinical predictors of its occurrence, and develop a new risk scale.
Methods: The incidence of HHF was estimated using data from the prospective single-center REFLEJA registry of outpatients with AF (October 2017-October 2018). A multivariate Cox regression model was calculated to detect HHF predictors, and a nomogram was created for individual risk assessment.
Results: Of the 1499 patients included (mean age 73.8±11.1 years, 48.1% women), 127 had HHF (incidence rate of 8.51 per 100 persons/y) and 319 died (rate of death from any cause of 21.1 per 100 persons/y) after a 3-year follow-up. The independent predictors of HHF were age, diabetes, chronic kidney disease, pulmonary hypertension, previous pacemaker implantation, baseline use of diuretics, and moderate-severe aortic regurgitation. The c-statistic for predicting the event was 0.762 (95%CI after boostrapping resampling, 0.753-0.791). The cumulative incidences of the main outcome for the risk scale quartiles were 1.613 (Q1), 3.815 (Q2), 8.378 (Q3), and 20.436 (Q4) cases per 100 persons/y (P <.001).
Conclusions: HHF was common in this AF cohort. The combination of certain clinical characteristics can identify patients with a very high risk of HHF.
(Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: