Min Cheng1, Xiangfeng Lu, Jianfeng Huang, Jian Zhang, Shu Zhang, Dongfeng Gu. 1. State Key Laboratory of Cardiovascular Disease, Department of Evidence Based Medicine, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beili Shi Road 167, Beijing, China.
Abstract
BACKGROUND: The prognostic significance of atrial fibrillation (AF) in patients with heart failure remains inconclusive. AIMS: To perform a meta-analysis of the published data to study the prognostic significance of AF in heart failure patients and to determine whether this relates to the presence of preserved or reduced left ventricular systolic function. METHODS AND RESULTS: We searched the MEDLINE (from inception to May 2014) supplemented by manual searches of references of relevant retrieved articles. Randomized clinic trials and observational studies were included with hazard ratios (HRs) of AF for mortality in chronic heart failure patients. The search strategy yielded 20 studies that met our eligibility criteria. A total of 61 240 AF patients in 152 306 heart failure participants were included, with 39 879 deaths occurring during follow-up. Pooled HRs for AF in mortality in heart failure was 1.17 (95% confidence intervals: 1.11-1.23) using random-effect model (I(2) = 44.5%). There was a significant difference of combined HRs between heart failure patients with preserved and reduced left ventricular ejection fraction (LVEF) in separate analysis. Sensitivity analysis supported the consistence of the results. CONCLUSIONS: Atrial fibrillation is significantly associated with increased mortality in heart failure patients. The prognostic significance of AF may be different between heart failure with preserved and reduced LVEF, and AF is associated with poorer prognosis in heart failure patients with preserved LVEF.
BACKGROUND: The prognostic significance of atrial fibrillation (AF) in patients with heart failure remains inconclusive. AIMS: To perform a meta-analysis of the published data to study the prognostic significance of AF in heart failurepatients and to determine whether this relates to the presence of preserved or reduced left ventricular systolic function. METHODS AND RESULTS: We searched the MEDLINE (from inception to May 2014) supplemented by manual searches of references of relevant retrieved articles. Randomized clinic trials and observational studies were included with hazard ratios (HRs) of AF for mortality in chronic heart failurepatients. The search strategy yielded 20 studies that met our eligibility criteria. A total of 61 240 AFpatients in 152 306 heart failureparticipants were included, with 39 879 deaths occurring during follow-up. Pooled HRs for AF in mortality in heart failure was 1.17 (95% confidence intervals: 1.11-1.23) using random-effect model (I(2) = 44.5%). There was a significant difference of combined HRs between heart failurepatients with preserved and reduced left ventricular ejection fraction (LVEF) in separate analysis. Sensitivity analysis supported the consistence of the results. CONCLUSIONS:Atrial fibrillation is significantly associated with increased mortality in heart failurepatients. The prognostic significance of AF may be different between heart failure with preserved and reduced LVEF, and AF is associated with poorer prognosis in heart failurepatients with preserved LVEF.
Authors: Emelia J Benjamin; Michael J Blaha; Stephanie E Chiuve; Mary Cushman; Sandeep R Das; Rajat Deo; Sarah D de Ferranti; James Floyd; Myriam Fornage; Cathleen Gillespie; Carmen R Isasi; Monik C Jiménez; Lori Chaffin Jordan; Suzanne E Judd; Daniel Lackland; Judith H Lichtman; Lynda Lisabeth; Simin Liu; Chris T Longenecker; Rachel H Mackey; Kunihiro Matsushita; Dariush Mozaffarian; Michael E Mussolino; Khurram Nasir; Robert W Neumar; Latha Palaniappan; Dilip K Pandey; Ravi R Thiagarajan; Mathew J Reeves; Matthew Ritchey; Carlos J Rodriguez; Gregory A Roth; Wayne D Rosamond; Comilla Sasson; Amytis Towfighi; Connie W Tsao; Melanie B Turner; Salim S Virani; Jenifer H Voeks; Joshua Z Willey; John T Wilkins; Jason Hy Wu; Heather M Alger; Sally S Wong; Paul Muntner Journal: Circulation Date: 2017-01-25 Impact factor: 29.690
Authors: Jürgen H Prochaska; Sebastian Göbel; Markus Nagler; Torben Knöpfler; Lisa Eggebrecht; Heidrun Lamparter; Marina Panova-Noeva; Karsten Keller; Meike Coldewey; Christoph Bickel; Michael Lauterbach; Roland Hardt; Christine Espinola-Klein; Hugo Ten Cate; Thomas Rostock; Thomas Münzel; Philipp S Wild Journal: Clin Res Cardiol Date: 2018-06-09 Impact factor: 5.460
Authors: Liang-Han Ling; Peter M Kistler; Jonathan M Kalman; Richard J Schilling; Ross J Hunter Journal: Nat Rev Cardiol Date: 2015-12-10 Impact factor: 32.419
Authors: Rajalakshmi Santhanakrishnan; Na Wang; Martin G Larson; Jared W Magnani; David D McManus; Steven A Lubitz; Patrick T Ellinor; Susan Cheng; Ramachandran S Vasan; Douglas S Lee; Thomas J Wang; Daniel Levy; Emelia J Benjamin; Jennifer E Ho Journal: Circulation Date: 2016-01-08 Impact factor: 29.690
Authors: Miriam A M Nji; Scott D Solomon; Lin Yee Chen; Amil M Shah; Elsayed Z Soliman; Aniqa B Alam; Vinita Subramanya; Alvaro Alonso Journal: Int J Cardiol Date: 2021-07-08 Impact factor: 4.039