Francisco Guillermo Clavel-Ruipérez1, Luciano Consuegra-Sánchez1, Francisco Javier Félix Redondo2, Luis Lozano Mera3, Pedro Mellado-Delgado2, Juan José Martínez-Díaz1, José Ramón López Mínguez4, Daniel Fernández-Bergés5. 1. Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain. 2. Unidad de Investigación, Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Servicio Extremeño de Salud, Área de Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain. 3. Unidad de Investigación, Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Servicio Extremeño de Salud, Área de Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain; Centro de Salud Urbano I, Servicio Extremeño de Salud, Mérida, Badajoz, Spain. 4. Unidad de Hemodinámica, Servicio de Cardiología, Hospital Universitario Infanta Cristina, Badajoz, Spain. 5. Unidad de Investigación, Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Servicio Extremeño de Salud, Área de Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain. Electronic address: polonibo@gmail.com.
Abstract
INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) is an independent risk factor for mortality in several diseases. However, data published in acute decompensated heart failure (DHF) are contradictory. Our objective was to investigate the impact of AF on mortality in patients admitted to hospital for DHF compared with those admitted for other reasons. METHODS: This retrospective cohort study included all patients admitted to hospital within a 10-year period due to DHF, acute myocardial infarction (AMI), or ischemic stroke (IS), with a median follow-up of 6.2 years. RESULTS: We included 6613 patients (74 ± 11 years; 54.6% male); 2177 with AMI, 2208 with DHF, and 2228 with IS. Crude postdischarge mortality was higher in patients with AF hospitalized for AMI (incident rate ratio, 2.48; P < .001) and IS (incident rate ratio, 1.84; P < .001) than in those without AF. No differences were found in patients with DHF (incident rate ratio, 0.90; P = .12). In adjusted models, AF was not an independent predictor of in-hospital mortality by clinical diagnosis. However, AF emerged as an independent predictor of postdischarge mortality in patients with AMI (HR, 1.494; P = .001) and IS (HR, 1.426; P < .001), but not in patients admitted for DHF (HR, 0.964; P = .603). CONCLUSIONS: AF was as an independent risk factor for postdischarge mortality in patients admitted to hospital for AMI and IS but not in those admitted for DHF.
INTRODUCTION AND OBJECTIVES:Atrial fibrillation (AF) is an independent risk factor for mortality in several diseases. However, data published in acute decompensated heart failure (DHF) are contradictory. Our objective was to investigate the impact of AF on mortality in patients admitted to hospital for DHF compared with those admitted for other reasons. METHODS: This retrospective cohort study included all patients admitted to hospital within a 10-year period due to DHF, acute myocardial infarction (AMI), or ischemic stroke (IS), with a median follow-up of 6.2 years. RESULTS: We included 6613 patients (74 ± 11 years; 54.6% male); 2177 with AMI, 2208 with DHF, and 2228 with IS. Crude postdischarge mortality was higher in patients with AF hospitalized for AMI (incident rate ratio, 2.48; P < .001) and IS (incident rate ratio, 1.84; P < .001) than in those without AF. No differences were found in patients with DHF (incident rate ratio, 0.90; P = .12). In adjusted models, AF was not an independent predictor of in-hospital mortality by clinical diagnosis. However, AF emerged as an independent predictor of postdischarge mortality in patients with AMI (HR, 1.494; P = .001) and IS (HR, 1.426; P < .001), but not in patients admitted for DHF (HR, 0.964; P = .603). CONCLUSIONS:AF was as an independent risk factor for postdischarge mortality in patients admitted to hospital for AMI and IS but not in those admitted for DHF.
Authors: Daniel Fernández-Bergés; Reyes González-Fernández; Francisco Javier Félix-Redondo; José Arevalo Lorido; Lorena Yeguas Rosa; Miriam Hernández-González; Alessia Rubini; Miguel Galán Montejano; María Carmen Gamero; Luis Lozano Mera Journal: Aten Primaria Date: 2022-05-13 Impact factor: 2.206