Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group

Stefania Paolillo, Piergiuseppe Agostoni, Daniele Masarone, Ugo Corrà, Claudio Passino, Domenico Scrutinio, Michele Correale, Gaia Cattadori, Marco Metra, Davide Girola, Massimo F. Piepoli, Elisabetta Salvioni, Marta Giovannardi, Annamaria Iorio, Michele Emdin, Rosa Raimondo, Federica Re, Mariantonietta Cicoira, Romualdo Belardinelli, Marco GuazziFrancesco Clemenza, Gianfranco Parati, Angela B. Scardovi, Andrea Di Lenarda, Rocco La Gioia, Maria Frigerio, Carlo Lombardi, Paola Gargiulo, Gianfranco Sinagra, Giuseppe Pacileo, Pasquale Perrone-Filardi, Giuseppe Limongelli

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF patients with reduced ejection fraction (EF). Methods HF patients were followed in 17 centers for 3.15 years (1.51-5.24). Study endpoints were the composite of cardiovascular (CV) death and heart transplant (HTX) and all-cause death. Data analysis was performed considering the entire population and a 1 to 1 match between sinus rhythm (SR) and AF patients. Match process was done for age ± 5, gender, left ventricle EF ± 5, peakVO2 ± 3 (ml/min/kg) and recruiting center. Results A total of 3447 patients (SR = 2882, AF = 565) were included in the study. Considering the entire population, CV death and HTX occurred in 114 (20%) AF vs. 471 (16%) SR (p = 0.026) and all-cause death in 130 (23%) AF vs. 554 (19.2%) SR patients (p = 0.039). At univariable Cox analysis, AF was significantly related to prognosis. Applying a multivariable model based on all variables significant at univariable analysis (EF, peakVO2, ventilation/carbon dioxide relationship slope, sodium, kidney function, hemoglobin, beta-blockers and digoxin) AF was no longer associated with adverse outcomes. Matching procedure resulted in 338 couples. CV death and HTX occurred in 63 (18.6%) AF vs. 74 (21.9%) SR (p = 0.293) and all-cause death in 71 (21%) AF vs. 80 (23.6%) SR (p = 0.406), with no survival differences between groups. Conclusion In systolic HF AF is a marker of disease severity but not an independent prognostic indicator.

Original languageEnglish
Pages (from-to)515-520
Number of pages6
JournalEuropean Journal of Internal Medicine
Volume26
Issue number7
DOIs
Publication statusPublished - Sep 1 2015

Fingerprint

Atrial Fibrillation
Heart Failure
Research
Cause of Death
Systolic Heart Failure
Digoxin
Carbon Dioxide
Population
Heart Ventricles
Ventilation
Hemoglobins
Sodium
Transplants
Kidney
Survival

Keywords

  • Atrial fibrillation
  • Heart failure
  • Matching analysis
  • MECKI score
  • Prognosis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group. / Paolillo, Stefania; Agostoni, Piergiuseppe; Masarone, Daniele; Corrà, Ugo; Passino, Claudio; Scrutinio, Domenico; Correale, Michele; Cattadori, Gaia; Metra, Marco; Girola, Davide; Piepoli, Massimo F.; Salvioni, Elisabetta; Giovannardi, Marta; Iorio, Annamaria; Emdin, Michele; Raimondo, Rosa; Re, Federica; Cicoira, Mariantonietta; Belardinelli, Romualdo; Guazzi, Marco; Clemenza, Francesco; Parati, Gianfranco; Scardovi, Angela B.; Di Lenarda, Andrea; La Gioia, Rocco; Frigerio, Maria; Lombardi, Carlo; Gargiulo, Paola; Sinagra, Gianfranco; Pacileo, Giuseppe; Perrone-Filardi, Pasquale; Limongelli, Giuseppe.

In: European Journal of Internal Medicine, Vol. 26, No. 7, 01.09.2015, p. 515-520.

Research output: Contribution to journalArticle

Paolillo, S, Agostoni, P, Masarone, D, Corrà, U, Passino, C, Scrutinio, D, Correale, M, Cattadori, G, Metra, M, Girola, D, Piepoli, MF, Salvioni, E, Giovannardi, M, Iorio, A, Emdin, M, Raimondo, R, Re, F, Cicoira, M, Belardinelli, R, Guazzi, M, Clemenza, F, Parati, G, Scardovi, AB, Di Lenarda, A, La Gioia, R, Frigerio, M, Lombardi, C, Gargiulo, P, Sinagra, G, Pacileo, G, Perrone-Filardi, P & Limongelli, G 2015, 'Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group', European Journal of Internal Medicine, vol. 26, no. 7, pp. 515-520. https://doi.org/10.1016/j.ejim.2015.04.023
Paolillo, Stefania ; Agostoni, Piergiuseppe ; Masarone, Daniele ; Corrà, Ugo ; Passino, Claudio ; Scrutinio, Domenico ; Correale, Michele ; Cattadori, Gaia ; Metra, Marco ; Girola, Davide ; Piepoli, Massimo F. ; Salvioni, Elisabetta ; Giovannardi, Marta ; Iorio, Annamaria ; Emdin, Michele ; Raimondo, Rosa ; Re, Federica ; Cicoira, Mariantonietta ; Belardinelli, Romualdo ; Guazzi, Marco ; Clemenza, Francesco ; Parati, Gianfranco ; Scardovi, Angela B. ; Di Lenarda, Andrea ; La Gioia, Rocco ; Frigerio, Maria ; Lombardi, Carlo ; Gargiulo, Paola ; Sinagra, Gianfranco ; Pacileo, Giuseppe ; Perrone-Filardi, Pasquale ; Limongelli, Giuseppe. / Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group. In: European Journal of Internal Medicine. 2015 ; Vol. 26, No. 7. pp. 515-520.
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title = "Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group",
abstract = "Background Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF patients with reduced ejection fraction (EF). Methods HF patients were followed in 17 centers for 3.15 years (1.51-5.24). Study endpoints were the composite of cardiovascular (CV) death and heart transplant (HTX) and all-cause death. Data analysis was performed considering the entire population and a 1 to 1 match between sinus rhythm (SR) and AF patients. Match process was done for age ± 5, gender, left ventricle EF ± 5, peakVO2 ± 3 (ml/min/kg) and recruiting center. Results A total of 3447 patients (SR = 2882, AF = 565) were included in the study. Considering the entire population, CV death and HTX occurred in 114 (20{\%}) AF vs. 471 (16{\%}) SR (p = 0.026) and all-cause death in 130 (23{\%}) AF vs. 554 (19.2{\%}) SR patients (p = 0.039). At univariable Cox analysis, AF was significantly related to prognosis. Applying a multivariable model based on all variables significant at univariable analysis (EF, peakVO2, ventilation/carbon dioxide relationship slope, sodium, kidney function, hemoglobin, beta-blockers and digoxin) AF was no longer associated with adverse outcomes. Matching procedure resulted in 338 couples. CV death and HTX occurred in 63 (18.6{\%}) AF vs. 74 (21.9{\%}) SR (p = 0.293) and all-cause death in 71 (21{\%}) AF vs. 80 (23.6{\%}) SR (p = 0.406), with no survival differences between groups. Conclusion In systolic HF AF is a marker of disease severity but not an independent prognostic indicator.",
keywords = "Atrial fibrillation, Heart failure, Matching analysis, MECKI score, Prognosis",
author = "Stefania Paolillo and Piergiuseppe Agostoni and Daniele Masarone and Ugo Corr{\`a} and Claudio Passino and Domenico Scrutinio and Michele Correale and Gaia Cattadori and Marco Metra and Davide Girola and Piepoli, {Massimo F.} and Elisabetta Salvioni and Marta Giovannardi and Annamaria Iorio and Michele Emdin and Rosa Raimondo and Federica Re and Mariantonietta Cicoira and Romualdo Belardinelli and Marco Guazzi and Francesco Clemenza and Gianfranco Parati and Scardovi, {Angela B.} and {Di Lenarda}, Andrea and {La Gioia}, Rocco and Maria Frigerio and Carlo Lombardi and Paola Gargiulo and Gianfranco Sinagra and Giuseppe Pacileo and Pasquale Perrone-Filardi and Giuseppe Limongelli",
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TY - JOUR

T1 - Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group

AU - Paolillo, Stefania

AU - Agostoni, Piergiuseppe

AU - Masarone, Daniele

AU - Corrà, Ugo

AU - Passino, Claudio

AU - Scrutinio, Domenico

AU - Correale, Michele

AU - Cattadori, Gaia

AU - Metra, Marco

AU - Girola, Davide

AU - Piepoli, Massimo F.

AU - Salvioni, Elisabetta

AU - Giovannardi, Marta

AU - Iorio, Annamaria

AU - Emdin, Michele

AU - Raimondo, Rosa

AU - Re, Federica

AU - Cicoira, Mariantonietta

AU - Belardinelli, Romualdo

AU - Guazzi, Marco

AU - Clemenza, Francesco

AU - Parati, Gianfranco

AU - Scardovi, Angela B.

AU - Di Lenarda, Andrea

AU - La Gioia, Rocco

AU - Frigerio, Maria

AU - Lombardi, Carlo

AU - Gargiulo, Paola

AU - Sinagra, Gianfranco

AU - Pacileo, Giuseppe

AU - Perrone-Filardi, Pasquale

AU - Limongelli, Giuseppe

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF patients with reduced ejection fraction (EF). Methods HF patients were followed in 17 centers for 3.15 years (1.51-5.24). Study endpoints were the composite of cardiovascular (CV) death and heart transplant (HTX) and all-cause death. Data analysis was performed considering the entire population and a 1 to 1 match between sinus rhythm (SR) and AF patients. Match process was done for age ± 5, gender, left ventricle EF ± 5, peakVO2 ± 3 (ml/min/kg) and recruiting center. Results A total of 3447 patients (SR = 2882, AF = 565) were included in the study. Considering the entire population, CV death and HTX occurred in 114 (20%) AF vs. 471 (16%) SR (p = 0.026) and all-cause death in 130 (23%) AF vs. 554 (19.2%) SR patients (p = 0.039). At univariable Cox analysis, AF was significantly related to prognosis. Applying a multivariable model based on all variables significant at univariable analysis (EF, peakVO2, ventilation/carbon dioxide relationship slope, sodium, kidney function, hemoglobin, beta-blockers and digoxin) AF was no longer associated with adverse outcomes. Matching procedure resulted in 338 couples. CV death and HTX occurred in 63 (18.6%) AF vs. 74 (21.9%) SR (p = 0.293) and all-cause death in 71 (21%) AF vs. 80 (23.6%) SR (p = 0.406), with no survival differences between groups. Conclusion In systolic HF AF is a marker of disease severity but not an independent prognostic indicator.

AB - Background Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF patients with reduced ejection fraction (EF). Methods HF patients were followed in 17 centers for 3.15 years (1.51-5.24). Study endpoints were the composite of cardiovascular (CV) death and heart transplant (HTX) and all-cause death. Data analysis was performed considering the entire population and a 1 to 1 match between sinus rhythm (SR) and AF patients. Match process was done for age ± 5, gender, left ventricle EF ± 5, peakVO2 ± 3 (ml/min/kg) and recruiting center. Results A total of 3447 patients (SR = 2882, AF = 565) were included in the study. Considering the entire population, CV death and HTX occurred in 114 (20%) AF vs. 471 (16%) SR (p = 0.026) and all-cause death in 130 (23%) AF vs. 554 (19.2%) SR patients (p = 0.039). At univariable Cox analysis, AF was significantly related to prognosis. Applying a multivariable model based on all variables significant at univariable analysis (EF, peakVO2, ventilation/carbon dioxide relationship slope, sodium, kidney function, hemoglobin, beta-blockers and digoxin) AF was no longer associated with adverse outcomes. Matching procedure resulted in 338 couples. CV death and HTX occurred in 63 (18.6%) AF vs. 74 (21.9%) SR (p = 0.293) and all-cause death in 71 (21%) AF vs. 80 (23.6%) SR (p = 0.406), with no survival differences between groups. Conclusion In systolic HF AF is a marker of disease severity but not an independent prognostic indicator.

KW - Atrial fibrillation

KW - Heart failure

KW - Matching analysis

KW - MECKI score

KW - Prognosis

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