Incidence and risk factors for atrial fibrillation in patients with newly diagnosed heart failure

Autor: Alexander Michel, Ruigómez A, García Rodríguez La, Martín-Pérez M
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Adrenergic beta-Antagonists
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Logistic regression
03 medical and health sciences
Young Adult
0302 clinical medicine
Age Distribution
Risk Factors
Internal medicine
Atrial Fibrillation
medicine
Odds Ratio
Humans
030212 general & internal medicine
Sex Distribution
Aged
First episode
Aged
80 and over

Heart Failure
Primary Health Care
business.industry
Incidence (epidemiology)
Incidence
valvular heart disease
Atrial fibrillation
General Medicine
Odds ratio
Middle Aged
medicine.disease
Confidence interval
United Kingdom
Logistic Models
Heart failure
Case-Control Studies
Cardiology
Female
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Journal of cardiovascular medicine (Hagerstown, Md.). 17(8)
ISSN: 1558-2035
Popis: AIMS We aimed to identify the incidence and risk factors for first ever atrial fibrillation among patients with newly diagnosed heart failure following initial heart failure diagnosis. METHODS A heart failure inception cohort of patients aged 20-89 years without atrial fibrillation or cancer (N = 14 457) from 2000 to 2005 was identified from The Health Improvement Network primary care database in the United Kingdom and followed for a mean of 2.67 years. First ever cases of atrial fibrillation were identified and controls (N = 3000) were frequency matched to cases by age and sex. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using unconditional logistic regression. RESULTS One thousand four hundred and eighty-nine patients (10.3%) developed a first episode of atrial fibrillation: incidence rate 27.3/1000 person-years. A three-fold increased risk of atrial fibrillation was seen in the first 6 months after heart failure diagnosis, OR 3.62 (95% CI: 2.97-4.42) with the risk decreasing thereafter. Other risk factors were excessive alcohol consumption (OR 2.91, 1.60-5.30) and valvular heart disease (OR 1.98, 1.63-2.40) and use of oral steroids (OR 1.76, 95% CI: 1.40-2.22). Reduced risks of atrial fibrillation were found with use of statins (OR 0.65, 95% CI: 0.56-0.76) and β-blockers (OR 0.78, 95% CI: 0.67-0.91). CONCLUSIONS The incidence of first ever atrial fibrillation among newly diagnosed heart failure patients is high, especially in the first 6 months after diagnosis. This time relationship, together with the identified risk factors for atrial fibrillation, warrants consideration in the medical care of patients with heart failure.
Databáze: OpenAIRE