Prognostic Impact of New-Onset Atrial Fibrillation in Patients With Chronic Heart Failure – A Report From the CHART-2 Study –
| Autor: | Yasuhiko Sakata, Satoshi Miyata, Takeo Onose, Shintaro Kasahara, Takuya Oikawa, Ruri Abe, Kotaro Nochioka, Kenjiro Sato, Hiroaki Shimokawa, Takeshi Yamauchi, Ryoichi Ushigome, Masanobu Miura, Soichiro Tadaki, Jun Takahashi, Kanako Tsuji |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class 030204 cardiovascular system & hematology Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Japan Internal medicine Atrial Fibrillation Humans Medicine Prospective Studies Registries 030212 general & internal medicine Survival rate Beta blocker Aged Aged 80 and over Heart Failure Ejection fraction business.industry Mortality rate Hazard ratio Atrial fibrillation General Medicine Middle Aged medicine.disease Brain natriuretic peptide Survival Rate Heart failure Chronic Disease Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Circulation Journal. 80:157-167 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-15-0783 |
| Popis: | Background The prognostic impact of new-onset atrial fibrillation (AF) is not fully elucidated. Methods and results We examined 4,818 consecutive stage C/D chronic heart failure (CHF) patients in the Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study (n=10,219). At enrollment, 1,859 (38.6%) of them had AF. Compared with the 2,953 patients without AF, AF patients were characterized by higher age (71 vs. 68 years), lower estimated glomerular filtration rate (58.9 vs. 61.9 ml/min/1.73 m(2)), higher brain natriuretic peptide (152 vs. 74.5 pg/ml), similar left ventricular ejection fraction (56.8 vs. 56.5%), and a similar prescription rate of β-blockers (48.1 vs. 50.6%) and renin-angiotensin system (RAS) inhibitors (72.9 vs. 71.6%). Among the patients without AF at enrollment, 106 (3.6%) developed new AF during the median 3.2-year follow-up, which was associated with increased mortality (adjusted hazard ratio, 1.72; P=0.013). In contrast, neither paroxysmal nor chronic AF at enrollment was associated with increased mortality. The mortality rate was significantly high in the first year after the onset of new AF. On inverse probability of treatment weighting analysis using propensity score, RAS inhibitors and statins were associated with reduced incidence of new AF, and diuretics were associated with increase of new AF. Conclusions Onset of new AF, but not a history of AF, is associated with increased mortality in CHF patients, especially in the first year. |
| Databáze: | OpenAIRE |
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