Previously known and newly diagnosed atrial fibrillation: a major risk indicator after a myocardial infarction complicated by heart failure or left ventricular dysfunction
| Autor: | Lars Køber, Steven L. Zelenkofske, Rafael Diaz, Georg Ertl, Faiez Zannad, Karl Swedberg, Jean-Lucien Rouleau, Jeffrey D. Leimberger, John J.V. McMurray, Aldo P. Maggioni, Viatcheslav Mareev, Frans Van de Werf, Marc A. Pfeffer, Scott D. Solomon, Robert M. Califf, Grzegorz Opolski, Eric J. Velazquez |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Randomization Captopril Time Factors Cardiac Output Low Myocardial Infarction Tetrazoles Risk Assessment Angina Ventricular Dysfunction Left Risk Factors Internal medicine Atrial Fibrillation Outcome Assessment Health Care medicine Humans Myocardial infarction Survival analysis Aged Proportional Hazards Models business.industry Atrial fibrillation Valine Middle Aged medicine.disease Prognosis Survival Analysis Valsartan Heart failure Acute Disease Cardiology Myocardial infarction complications Female Cardiology and Cardiovascular Medicine business Angiotensin II Type 1 Receptor Blockers medicine.drug |
| Zdroj: | European journal of heart failure. 8(6) |
| ISSN: | 1388-9842 |
| Popis: | Aims To characterize the relationship between known and newly diagnosed atrial fibrillation (AF) and the risk of death and major cardiovascular (CV) events in patients with acute myocardial infarction (MI) complicated by heart failure (HF) and/or left ventricular systolic dysfunction (LVSD). Methods The VALIANT trial enrolled 14,703 individuals with acute MI complicated by HF and/or LVSD. AF was assessed at presentation and at randomization (median 4.9 days after symptom onset). Primary outcomes were risk of death and major CV events 3 years following acute MI. Results A total of 1812 with current AF (AF between presentation and randomization), 339 patients with prior AF (history of AF without current AF), and 12,509 without AF were enrolled. Patients with AF were older; had more prior HF, angina, and MI, and received beta-blockers and thrombolytics less often than those without AF. Three-year mortality estimates were 20% in those without AF, 37% with current AF, and 38% with prior AF. Compared with patients without AF, the multivariable adjusted HR of death was 1.25 (1.03–1.52; p = 0.03) for prior AF and 1.32 (1.20–1.45; p < 0.0001) for current AF. HR for major CV events was 1.15 (0.98–1.35; p = 0.08) and 1.21 (1.12–1.31; p < 0.0001). Conclusion AF is associated with greater long-term mortality and adverse CV events with acute MI complicated by HF or LVSD. |
| Databáze: | OpenAIRE |
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