Afib independently tied to higher mortality risk in acute heart failure

  • Anderson SG & al.
  • Clin Res Cardiol
  • 8 Apr 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with acute heart failure (AHF), atrial fibrillation (Afib) is independently associated with a higher risk for all-cause mortality during hospital admission and up to 1-year post-discharge.

Why this matters

  • Afib is associated with adverse prognosis in patients with chronic heart failure; however, little is known about its prognostic effect in patients with AHF.

Study design

  • Study included 96,593 patients admitted with a primary death or discharge diagnosis of AHF in England and Wales using data from the National HF Audit (NHFA) collected between 2012 and 2013.
  • Primary outcome: all-cause mortality as an inpatient, at 30 days, 1 year and all deaths.
  • Funding: None disclosed.

Key results

  • Of 96,593 patients with AHF, 44,642 (46%) were in sinus rhythm (SR) and 51,951 (54%) in Afib.
  • Patients with Afib vs those with SR were significantly older (mean age: 79.8 (79.7-80) vs 74.7 (74.5-74.7) years; P<.001 and had higher mean heart rate vs bpm p>
  • In a multivariable analysis, Afib was independently associated with in-hospital (HR, 1.15), 30-day (HR, 1.13) and 1-year (HR, 1.09) all-cause mortality, and all deaths (HR, 1.08; P<.0001 for all>
  • In subgroup analyses, Afib was independently associated with worse 30-day mortality irrespective of sex, ventricular phenotype and in all age groups except in those patients aged between 55-64 (HR, 1.04; P=.69) and 65-74 years (HR, 1.09; P=.14).

Limitations

  • Observational design.

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