MiscellaneousImpact of Atrial Fibrillation and Heart Failure, Independent of Each Other and in Combination, on Mortality in Community-Dwelling Older Adults
Section snippets
Methods
We used a public-use copy of the Cardiovascular Health Study (CHS) data obtained from the National Heart, Lung and Blood Institute, which also sponsored the study. The CHS is an ongoing, prospective, community-based, epidemiologic study of cardiovascular (CV) disease risk factors among participants aged ≥65 years, the rationale and design of which have been previously reported.7 The 5,888 Medicare-eligible CHS participants were recruited in 2 phases (1989 to 1990 and 1992 to 1993) from 4 US
Results
Participants (n = 5,673) had a mean (±SD) age of 73 years (±6), 58% were women, and 15% were African-American. Compared with those with neither condition, those with both AF and HF were more likely to be women, with lesser income, self-reported poor health, and greater prevalence of CV risk factors (Table 1).
During 13 years of follow-up, all-cause mortality occurred in 43%, 66%, 74%, and 85% of those with neither, AF only, HF only, and both, respectively (Table 2). Compared with the neither
Discussion
Findings from our study demonstrate that among community-dwelling older adults, compared with those without AF or HF, the presence of AF (without HF) was associated with significantly greater all-cause mortality, which was delayed until after the first 6 years of follow-up and was driven by a greater CV mortality. In contrast, those with HF (without AF) had greater all-cause mortality that occurred sooner and was also associated with greater CV and non-CV mortalities, compared with those with
Disclosures
Dr. Ahmed was in part supported by NIH grants R01-HL085561 and R01-HL097047 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland, and an intramural support from the UAB Comprehensive Cardiovascular Center, Birmingham, Alabama. The authors have no conflicts of interest to disclose.
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2019, International Journal of CardiologyCitation Excerpt :Compared to healthy individuals the manifestation of both, AF or HF, is related to a poor prognosis. The co-occurrence however, is associated with a particularly high cardiovascular and all-cause mortality [182,221]. Notably, new onset of AF in individuals suffering from HF has a stronger negative impact on prognosis than previously diagnosed AF [222–224].
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The Prognostic Significance of Cardiac Structure and Function in Atrial Fibrillation: The ENGAGE AF-TIMI 48 Echocardiographic Substudy
2016, Journal of the American Society of EchocardiographyCitation Excerpt :Larger LV size and higher LV filling pressures may be indicative of volume overload conditions, such as heart failure or chronic kidney disease. The complex associations between AF and heart failure are well recognized, and heart failure may be an important mediator of the risk for sudden cardiac death among patients with AF.2,24-26 Indeed, sudden cardiac death and heart failure were the leading causes of cardiovascular death in this cohort.
Digoxin in patients with atrial fibrillation and heart failure: A meta-analysis
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2019, Revista Colombiana de Cardiologia
Drs. Bajaj and Bhatia contributed equally and are co-primary authors.
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