Does rhythm matter in Acute Heart Failure? An insight from the British Society for Heart Failure National Audit

Anderson, S. G., Shoaib, A., Myint, P. K., Cleland, J. G. , Hardman, S. M., McDonagh, T. A., Dargie, H., Keavney, B., Garratt, C. J. and Mamas, M. A. (2019) Does rhythm matter in Acute Heart Failure? An insight from the British Society for Heart Failure National Audit. Clinical Research in Cardiology, (doi:10.1007/s00392-019-01463-5) (PMID:30963233)

[img]
Preview
Text
182977.pdf - Published Version
Available under License Creative Commons Attribution.

903kB

Abstract

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with acute heart failure (AHF). The presence of AF is associated with adverse prognosis in patients with chronic heart failure (CHF) but little is known about its impact in AHF. Methods: Data were collected between April 2007 and March 2013 across 185 (> 95%) hospitals in England and Wales from patients with a primary death or a discharge diagnosis of AHF. We investigated the association between the presence of AF and all-cause mortality during the index hospital admission, at 30 days and 1 year post-discharge. Results: Of 96,593 patients admitted with AHF, 44,642 (46%) were in sinus rhythm (SR) and 51,951 (54%) in AF. Patients with AF were older (mean age 79.8 (79.7–80) versus 74.7 (74.5–74.7) years; p < 0.001), than those in SR. In a multivariable analysis, AF was independently associated with mortality at all time points, in hospital (HR 1.15, 95% CI 1.09–1.21, p < 0.0001), 30 days (HR 1.13, 95% CI 1.08–1.19, p < 0.0001), and 1 year (HR 1.09, 95% CI 1.05–1.12, p < 0.0001). In subgroup analyses, AF was independently associated with worse 30-day outcome irrespective of sex, ventricular phenotype and in all age groups except in those aged between 55 and 74 years. Conclusion: AF is independently associated with adverse prognosis in AHF during admission and up to 1 year post-discharge. As the clinical burden of concomitant AF and AHF increases, further refinement in the detection, treatment and prevention of AF-related complications may have a role in improving patient outcomes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dargie, Professor Henry and Cleland, Professor John
Authors: Anderson, S. G., Shoaib, A., Myint, P. K., Cleland, J. G., Hardman, S. M., McDonagh, T. A., Dargie, H., Keavney, B., Garratt, C. J., and Mamas, M. A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Clinical Research in Cardiology
Publisher:Springer
ISSN:1861-0684
ISSN (Online):1861-0692
Published Online:08 April 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Clinical Research in Cardiology 2019
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record

Downloads per month over past year

View more statistics