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 language | English |
|---|---|
| Pages (from-to) | 515-520 |
| Number of pages | 6 |
| Journal | European Journal of Internal Medicine |
| Volume | 26 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Sep 1 2015 |
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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 journal › Article
}
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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U2 - 10.1016/j.ejim.2015.04.023
DO - 10.1016/j.ejim.2015.04.023
M3 - Article
VL - 26
SP - 515
EP - 520
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
SN - 0953-6205
IS - 7
ER -