Atrial fibrillation, ischaemic heart disease, and the risk of death in patients with heart failure

• Published in: European heart journal 2006-12, Vol.27 (23), p.2866-2870
• Main Authors: Pedersen, Ole Dyg, Søndergaard, Peter, Nielsen, Tonny, Nielsen, Søren Junge, Nielsen, Eric Steen, Falstie-Jensen, Niels, Nielsen, Ingolf, Køber, Lars, Burchardt, Hans, Seibaek, Marie, Torp-Pedersen, Christian
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Atrial Fibrillation - mortality; Denmark - epidemiology; Female; Heart Failure - mortality; Hospital Mortality; Humans; Male; Middle Aged; Myocardial Ischemia - mortality; Prognosis; Regression Analysis; Risk Factors
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehl359

Atrial fibrillation (AF) is a risk factor for death in patients with a myocardial infarction, but highly variable results are reported in patients with heart failure. We studied the prognostic impact of AF in heart failure patients with and without ischaemic heart disease. During a period of 2 years, 3587 patients admitted to hospital because of heart failure were included in this study. All patients were examined by echocardiography and the presence of AF was recorded. Follow-up was available for 8 years. Twenty four percent of those discharged alive from hospital had AF. After 4 and 8 years of follow-up, mortality was higher in patients with AF than in patients without, 56 vs. 52% and 77 vs. 73%, respectively. Cox multivariable regression analysis showed a small but significant importance of AF for long-term mortality [hazard ratio (HR) 1.12, 95% confidence limits (CI), 1.02-1.23, P=0.018]. There was a significant interaction between the importance of AF and the presence of ischaemic heart disease (P=0.034). In patients with AF at the time of discharge and ischaemic heart disease, HR was 1.25 (95% CI: 1.09-1.42) and P