AF increases mortality risk in HF patients with underlying IHD
MedWire News: Presence of atrial fibrillation (AF) is only associated with increased risk for death in heart failure (HF) patients who have underlying ischemic heart disease (IHD), report researchers.
Around half of all patients with HF also have AF, but its prognostic significance is still the subject of debate, as study results have been conflicting.
Jakob Raunsø (Copenhagen University Hospital, Herlev, Denmark) and colleagues assessed the prognostic significance of AF in a population of 2881 patients with HF who were admitted to hospital with worsening symptoms between 2001 and 2004. All the patients were participating in the Echocardiography and Heart Outcomes Study (ECHOS).
The researchers followed the participants for up to 7 years for all-cause mortality stratified according to heart rhythm - sinus rhythm, paroxysmal AF, or chronic AF - and presence of IHD.
During the follow-up period, 1934 patients died. In patients with both HF and IHD, chronic, but not paroxysmal AF, was associated with an increased relative risk for death compared with no AF, at a hazard ratio of 1.44 (p<0.001).
In contrast, for patients with HF but no IHD, presence of chronic AF did not significantly increase the risk for death.
"Previous studies have clearly shown a detrimental effect of AF in populations with IHD and in the general population, but the prognostic impact of AF in a HF population has been somewhat controversial," explain Raunsø and co-workers.
"Our study suggests that subgroups of AF patients with HF have different prognoses and that differentiated treatment options may be needed for these groups," write the authors in the European Journal of Heart Failure.
"Prospective research in this field is warranted," they say.
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By Helen Albert