Horodinschi RN, Diaconu CC. Comorbidities Associated with One-Year Mortality in Patients with Atrial Fibrillation and Heart Failure.
Healthcare (Basel) 2021;
9:830. [PMID:
34356208 PMCID:
PMC8303755 DOI:
10.3390/healthcare9070830]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND
Heart failure (HF) and atrial fibrillation (AF) commonly coexist and patients with both diseases have a worse prognosis than those with HF or AF alone. The objective of our study was to identify the factors associated with one-year mortality in patients with HF and AF, depending on the left ventricular ejection fraction (LVEF).
METHODS
We included 727 patients with HF and AF consecutively admitted in a clinical emergency hospital between January 2018 and December 2019. The inclusion criteria were age of more than 18 years, diagnosis of chronic HF and AF (paroxysmal, persistent, permanent), and signed informed consent. The exclusion criteria were the absence of echocardiographic data, a suboptimal ultrasound view, and other cardiac rhythms than AF. The patients were divided into 3 groups: group 1 (337 patients with AF and HF with reduced ejection fraction (HFrEF)), group 2 (112 patients with AF and HF with mid-range ejection fraction (HFmrEF)), and group 3 (278 patients with AF and HF with preserved ejection fraction (HFpEF)).
RESULTS
The one-year mortality rates were 36.49% in group 1, 27.67% in group 2, and 27.69% in group 3. The factors that increased one-year mortality were chronic kidney disease (OR 2.35, 95% CI 1.45-3.83), coronary artery disease (OR 1.67, 95% CI 1.06-2.62), and diabetes (OR 1.66, 95% CI 1.05-2.67) in patients with HFrEF; and hypertension in patients with HFpEF (OR 2.45, 95% CI 1.36-4.39).
CONCLUSIONS
One-year mortality in patients with HF and AF is influenced by different factors, depending on the LVEF.
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