Key result
Atrial fibrillation at presentation in heart failure patients was not associated with increased mortality after covariate adjustment, despite higher 3-year crude mortality.
Why the study?
Does atrial fibrillation at presentation increase mortality in patients hospitalized with heart failure?
Observational (n=2,593)
Yes
Does atrial fibrillation at presentation increase mortality in patients hospitalized with heart failure?
In patients hospitalized with heart failure, the presence of atrial fibrillation at presentation is not independently associated with increased mortality after adjusting for covariates.
Answers are grounded in this paper and cite their sources.
AF at HF presentation is not independently linked to higher mortality; leaves open whether rhythm strategies affect outcomes in adjusted cohorts.
Effect of atrial fibrillation (AF) on short- and long-term outcomes in heart failure (HF) is controversial. Accordingly, we examined this relationship in a national multicenter project using data from the Hearts Function Assessment Registry Trial in Saudi Arabia that studied the clinical features and outcomes of patients admitted with de novo and acute on chronic HF. Out of 2593 patients with HF, 449 (17.8%) had AF at presentation. Patients with AF were more likely to be males and older (mean age 65.2 ± 15.0 vs 60.5 ± 14.8 years) to have a history of ventricular tachycardia/ventricular fibrillation (3.1% vs 1.9%) or cerebrovascular accident (15.0% vs 8.5%). However, they were less likely to have diabetes (66.0% vs 55.9%) or coronary artery disease (55.6% vs 42.3%). The 1-, 2-, and 3-year crude mortality rates were significantly higher in patients with AF (23.2% vs 18.3%, 27.4% vs 22.3%, and 27.8% vs 23.2%, respectively). However, there was no significant difference in mortality after adjusting for covariates. Thus, in patients admitted with HF, AF upon presentation was not associated with increased mortality.
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Ajlan et al. (2017) conducted an observational in Heart failure (n=2,593). Atrial fibrillation at presentation vs. No atrial fibrillation was evaluated on 3-year crude mortality. Atrial fibrillation at presentation in heart failure patients was not associated with increased mortality after covariate adjustment, despite higher 3-year crude mortality (27.8% vs 23.2%).
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