Atrial fibrillation and long-term prognosis in patients hospitalized for heart failure: results from heart failure survey in Israel (HFSIS)

Aims Atrial fibrillation (AF) and heart failure (HF) commonly coexist, and each adversely affects the other. The aim of the study was to prospectively evaluate the impact of AF and its subtypes on management, and early and long-term outcome of hospitalized HF patients. Methods and results Data were...

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Bibliographic Details
Published in:European heart journal 2010-02, Vol.31 (3), p.309-317
Main Authors: Shotan, Avraham, Garty, Moshe, Blondhein, David S., Meisel, Simcha R., Lewis, Basil S., Shochat, Michael, Grossman, Ehud, Porath, Avi, Boyko, Valentina, Zimlichman, Reuven, Caspi, Abraham, Gottlieb, Shmuel
Format: Article
Language:English
Subjects:
Aged
Atrial fibrillation
Atrial Fibrillation - complications
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Chronic Disease
Female
Heart
Heart failure
Heart Failure - complications
Heart Failure - mortality
Heart Failure - therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Hospitalization - statistics & numerical data
Humans
Male
Medical sciences
Prognosis
Prospective Studies
Thromboembolism - prevention & control
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - mortality
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Summary:Aims Atrial fibrillation (AF) and heart failure (HF) commonly coexist, and each adversely affects the other. The aim of the study was to prospectively evaluate the impact of AF and its subtypes on management, and early and long-term outcome of hospitalized HF patients. Methods and results Data were prospectively collected on HF patients hospitalized in all public hospitals in Israel as part of a national survey (HFSIS). Atrial fibrillation patients were subdivided into intermittent and chronic AF subgroups. During March–April 2003, we enrolled 4102 HF patients, of whom 1360 (33.2%) had AF [600 (44.1%) intermittent, 562 (41.3%) chronic]. Patients with AF were older (76.9 ± 10.5 vs. 71.7 ± 12.6 years, P = 0.0001), males, with preserved LV systolic function. Crude mortality rates for AF patients were progressively and consistently higher during hospitalization and during the 4-year follow-up period, especially in the chronic AF group (P = 0.0001). After covariate adjustment, AF was associated with increased 1-year mortality [HR 1.19, 95% CI (1.03–1.36)]. Conclusion AF was present in a third of hospitalized HF patients, and identified a population with increased mortality risk, largely due to co-morbidities.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehp422