Atrial fibrillation independently predicted 1-year all-cause mortality in heart failure outpatients aged ≤65 years (HR 1.42; 95% CI 1.10-1.81) and 66-75 years, but not in those >75 years.
Cohort (n=8,178)
Yes
Does atrial fibrillation predict 1-year all-cause mortality differently across age groups in outpatients with chronic heart failure?
Atrial fibrillation is an independent predictor of 1-year mortality in heart failure patients aged 75 years or younger, but loses its independent prognostic value in older patients.
Effect estimate: HR 1.42 (≤65 years), HR 1.29 (66-75 years), HR 1.05 (>75 years) (95% CI 1.10-1.81 (≤65 years), 1.00-1.67 (66-75 years), 0.78-1.43 (>75 years))
OBJECTIVES: The role of atrial fibrillation (AF) in older patients with heart failure (HF) is controversial because many variables seem to influence their outcome. We investigated the predictivity of AF in 3 age groups of outpatients with HF. METHODS: We analyzed 8,178 outpatients enrolled in the Italian Network on Congestive Heart Failure Registry with HF diagnosed according to the European Society of Cardiology criteria. A trained cardiologist established the diagnosis of AF and HF at the entry visit at each center. We stratified the population into 3 age groups, as follows: group A, 75 years. RESULTS: Group A was composed of 4,261 patients, 683 with AF (16.0%); in group B there were 2,651 patients, 638 with AF (24.1%), and group C was composed of 1,266 patients, 412 with AF (32.5%). The 1-year mortality rate was higher in AF patients in all groups. In a multivariate model, AF remained an independent risk factor for death in groups A and B, but not in group C group A: hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.10-1.81; group B: HR 1.29, 95% CI 1.00-1.67; group C: HR 1.05, 95% CI 0.78-1.43. CONCLUSION: The prevalence of AF increased with age and was associated with a higher mortality rate. However, AF independently predicted all-cause mortality only in patients aged < or =75 years.
Baldasseroni et al. (Fri,) conducted a cohort in Chronic Heart Failure (n=8,178). Atrial fibrillation vs. No atrial fibrillation was evaluated on 1-year all-cause mortality (HR 1.42 (≤65 years), HR 1.29 (66-75 years), HR 1.05 (>75 years), 95% CI 1.10-1.81 (≤65 years), 1.00-1.67 (66-75 years), 0.78-1.43 (>75 years)). Atrial fibrillation independently predicted 1-year all-cause mortality in heart failure outpatients aged ≤65 years (HR 1.42; 95% CI 1.10-1.81) and 66-75 years, but not in those >75 years.