Heart failureRecent Trends in the Incidence, Treatment, and Prognosis of Patients With Heart Failure and Atrial Fibrillation (the Worcester Heart Failure Study)
Section snippets
Methods
The Worcester Heart Failure Study is a community-based investigation of adult residents from the Worcester, Massachusetts, metropolitan area (2000 census population estimates 478,000) who were hospitalized for ADHF at any of the 11 greater Worcester medical centers during 4 study years (1995, 2000, 2002, and 2004). Primary and/or secondary “International Classification of Diseases” discharge diagnoses consistent with possible HF were reviewed in a standardized fashion, as previously outlined in
Results
The mean age of the study participants was 76.2 years, 56.1% were women, and 93.3% were white. Of the 9,748 patients admitted with ADHF from 1995 to 2004, 3,868 patients (39.7%) had a history of AF and 449 (4.6%) developed new-onset AF during hospitalization (Table 1). Greater rates of new-onset AF were observed in patients without a history of HF (7.0% vs 3.6%).
The rates of new-onset AF remained stable from 1995 to 2004 (4.9% to 5.0%), and the proportion of patients with pre-existing AF (34.5%
Discussion
Within a community-based cohort of almost 10,000 patients hospitalized with ADHF during a nearly decade-long period, we have demonstrated that pre-existing and new-onset AF are common in these ill patients and that the proportion of patients hospitalized with pre-existing AF and HF is increasing.
AF and HF frequently coexist and have similar risk factors, with each condition predisposing to the other.21 Estimates on the prevalence of AF among patients hospitalized with AF vary (15% to 35%);
References (27)
- et al.
Atrial fibrillation in congestive heart failure
Heart Fail Clin
(2010) - et al.
Epidemiology of decompensated heart failure in a single community in the northeastern United States
Am J Cardiol
(2009) - et al.
Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials: studies of left ventricular dysfunction
J Am Coll Cardiol
(1998) - et al.
Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective
J Am Coll Cardiol
(1995) - et al.
Influence of patient age and sex on delivery of guideline-recommended heart failure care in the outpatient cardiology practice setting: findings from IMPROVE-HF
Am Heart J
(2009) - et al.
Lifetime risk for developing congestive heart failure: the Framingham Heart Study
Circulation
(2002) - et al.
Lifetime risk for development of atrial fibrillation: the Framingham Heart Study
Circulation
(2004) Atrial fibrillation: an emerging epidemic?
Heart
(2004)- et al.
Atrial fibrillation as an independent risk factor for stroke: the Framingham study
Stroke
(1991) - et al.
Impact of atrial fibrillation on the risk of death: the Framingham Heart Study
Circulation
(1998)
Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study
Circulation
Overview of acutely decompensated congestive heart failure (ADHF): a report from the ADHERE registry
Heart Fail Rev
Recent progress in the epidemiology of atrial fibrillation
Curr Opin Cardiol
Cited by (28)
NT-proBNP cut-off value for ruling out heart failure in atrial fibrillation patients – A prospective clinical study
2023, American Journal of Emergency MedicineDecade-Long Trends (2001 to 2011) in the Use of Evidence-Based Medical Therapies at the Time of Hospital Discharge for Patients Surviving Acute Myocardial Infarction
2016, American Journal of CardiologyCitation Excerpt :Cases of perioperative-associated AMI were not included. The various complications of AMI, including atrial fibrillation, heart failure, and cardiogenic shock, were assessed based on information available from clinical charts.1–7 The medications of interest in this investigation included aspirin, angiotensin-converting enzyme (ACE) inhibitors/ARBs, β blockers, and statins; CMT was defined as the hospital prescription of all 4 cardiac medications.
Prevalence and prognostic meaning of comorbidity in heart failure
2016, Revista Clinica EspanolaNew-onset versus prior history of atrial fibrillation: Outcomes from the AFFIRM trial
2015, American Heart JournalCitation Excerpt :To our knowledge, our study is the first to evaluate mortality outcomes between patients with new-onset AF versus those with prior history of AF. Multiple reports reveal a strong association between all-cause mortality and new-onset AF (vs non-AF) patients with different risk profiles.3,7,8 This is consistent with our findings in the unadjusted model that new-onset AF was associated with higher mortality (vs prior AF).
Characteristics of the population hospitalized for advanced and terminal heart failure and experiences in palliative caring in the Intensive Care Unit of cardiology
2015, Annales de Cardiologie et d'Angeiologie
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