Oliver J Ziff1, Paul R Carter2, John McGowan3, Hardeep Uppal4, Suresh Chandran4, Stuart Russell5, Kevin R Bainey6, Rahul Potluri7. 1. Institute of Cardiovascular Science, University College London, London, UK; Royal Free London NHS Foundation Trust, London, UK. 2. Institute of Cardiovascular Science, University College London, London, UK; Royal Free London NHS Foundation Trust, London, UK; ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK. 3. Institute of Cardiovascular Science, University College London, London, UK. 4. ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK. 5. East Cheshire NHS Trust, Macclesfield, UK. 6. Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. 7. ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, UK; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada. Electronic address: ACALMstudy@outlook.com.
Abstract
BACKGROUND: There is concern that the development of heart failure and atrial fibrillation has a detrimental influence on clinical outcomes. The aim of this study was to assess all-cause mortality and length of hospital stay in patients with chronic and new-onset concomitant AF and HF. METHODS: Using the ACALM registry, we analysed adults hospitalised between 2000 and 2013 with AF and HF and assessed prevalence, mortality and length of hospital stay. Patients with HF and/or AF at baseline (study-entry) were compared with patients who developed new-onset disease during follow-up. RESULTS: Of 929,552 patients, 31,695 (3.4%) were in AF without HF, 20,768 (2.2%) had HF in sinus rhythm, and 10,992 (1.2%) had HF in AF. Patients with HF in AF had the greatest all-cause mortality (70.8%), followed by HF in sinus rhythm (64.1%) and AF alone (45.1%, p<0.0001). Patients that developed new-onset AF, HF or both had significantly worse mortality (58.5%, 70.7% and 74.8% respectively) compared to those already with the condition at baseline (48.5%, 63.7% and 67.2% respectively, p<0.0001). Patients with HF in AF had the longest length of hospital stay (9.41days, 95% CI 8.90-9.92), followed by HF in sinus rhythm (7.67, 95% CI 7.34-8.00) and AF alone (6.05, 95% CI 5.78-6.31). CONCLUSIONS: Patients with HF in AF are at a greater risk of mortality and longer hospital stay compared to patients without the combination. New-onset AF or HF is associated with significantly worse prognosis than long-standing disease.
BACKGROUND: There is concern that the development of heart failure and atrial fibrillation has a detrimental influence on clinical outcomes. The aim of this study was to assess all-cause mortality and length of hospital stay in patients with chronic and new-onset concomitant AF and HF. METHODS: Using the ACALM registry, we analysed adults hospitalised between 2000 and 2013 with AF and HF and assessed prevalence, mortality and length of hospital stay. Patients with HF and/or AF at baseline (study-entry) were compared with patients who developed new-onset disease during follow-up. RESULTS: Of 929,552 patients, 31,695 (3.4%) were in AF without HF, 20,768 (2.2%) had HF in sinus rhythm, and 10,992 (1.2%) had HF in AF. Patients with HF in AF had the greatest all-cause mortality (70.8%), followed by HF in sinus rhythm (64.1%) and AF alone (45.1%, p<0.0001). Patients that developed new-onset AF, HF or both had significantly worse mortality (58.5%, 70.7% and 74.8% respectively) compared to those already with the condition at baseline (48.5%, 63.7% and 67.2% respectively, p<0.0001). Patients with HF in AF had the longest length of hospital stay (9.41days, 95% CI 8.90-9.92), followed by HF in sinus rhythm (7.67, 95% CI 7.34-8.00) and AF alone (6.05, 95% CI 5.78-6.31). CONCLUSIONS:Patients with HF in AF are at a greater risk of mortality and longer hospital stay compared to patients without the combination. New-onset AF or HF is associated with significantly worse prognosis than long-standing disease.
Authors: Jake P Mann; Paul Carter; Matthew J Armstrong; Hesham K Abdelaziz; Hardeep Uppal; Billal Patel; Suresh Chandran; Ranjit More; Philip N Newsome; Rahul Potluri Journal: PLoS One Date: 2020-10-27 Impact factor: 3.240