+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Recent trends in the incidence, treatment, and prognosis of patients with heart failure and atrial fibrillation (the Worcester Heart Failure Study)



Recent trends in the incidence, treatment, and prognosis of patients with heart failure and atrial fibrillation (the Worcester Heart Failure Study)



American Journal of Cardiology 111(10): 1460-1465



Atrial fibrillation (AF) and heart failure (HF) are common cardiovascular diseases and the co-occurrence of AF and HF has been associated with reduced survival. Data are needed on the potentially changing trends in the characteristics, treatment, and prognosis of patients with acute decompensated HF (ADHF) and AF. The study population consisted of 9,748 patients hospitalized with ADHF at 11 hospitals in the Worcester, Massachusetts, metropolitan area during 4 study years (1995, 2000, 2002, and 2004). Of the 9,748 patients admitted with ADHF, 3,868 (39.7%) had a history of AF and 449 (4.6%) developed new-onset AF during hospitalization. The rates of new-onset AF remained stable (4.9% in 1995; 5.0% in 2004), but the proportion of patients with pre-existing AF (34.5% in 1995; 41.6% in 2004) increased over time. New-onset and pre-existing AF were associated with older age, but pre-existing AF was more closely linked to a greater co-morbid disease burden. The use of HF therapies did not differ greatly by AF status. Despite this, new-onset AF was associated with a longer length of stay (7.5 vs 6.1 days) and greater in-hospital death rates (11.4% vs 6.6%). In contrast, pre-existing AF was associated with lower rates of postdischarge survival compared to patients with no AF (p <0.05 for all). The mortality rates improved significantly over time in patients with AF. In conclusion, AF was common among patients with ADHF, and the proportion of ADHF patients with co-occurring AF increased during the study period. Despite improving trends in survival, patients with ADHF and AF are at increased risk of in-hospital and postdischarge mortality.

(PDF emailed within 0-6 h: $19.90)

Accession: 055403161

Download citation: RISBibTeXText

PMID: 23465093

DOI: 10.1016/j.amjcard.2013.01.298


Related references

Time trends in the incidence and prognosis of congestive heart failure associated with acute myocardial infarction The Worcester Heart Attack Study. Circulation 90(4 PART 2): I283, 1994

Rationale and design of a study assessing treatment strategies of atrial fibrillation in patients with heart failure: The Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial. American Heart Journal 144(4): 597-607, 2002

Atrial fibrillation and long-term prognosis in patients hospitalized for heart failure: results from heart failure survey in Israel (HFSIS). European Heart Journal 31(3): 309-317, 2011

Impact of COPD on the mortality and treatment of patients hospitalized with acute decompensated heart failure: the Worcester Heart Failure Study. Chest 147(3): 637-645, 2015

Clinical features, treatment practices, and hospital and long-term outcomes of older patients hospitalized with decompensated heart failure: The Worcester Heart Failure Study. Journal of the American Geriatrics Society 57(9): 1587-1594, 2009

Does the prevalence of atrial fibrillation vary by race in patients with heart failure? The epidemiology, practice, outcomes, and costs of heart failure Study. Journal of the American College of Cardiology 41(6 Supplement A): 149A, March 19, 2003

Risk of Stroke in Chronic Heart Failure Patients Without Atrial Fibrillation: Analysis of the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) and the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure (GISSI-HF) Trials. Circulation 131(17): 1486-94; Discussion 1494, 2015

Prognostic value of the physical examination in patients with heart failure and atrial fibrillation: insights from the AF-CHF trial (atrial fibrillation and chronic heart failure). Jacc. Heart Failure 2(1): 15-23, 2015

Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) study. Journal of the American College of Cardiology 43(3): 429-435, 2004

Gender Differences in Presentation, Treatment, and In-Hospital Outcome of Patients Admitted With Heart Failure Complicated by Atrial Fibrillation (from the Get With the Guidelines-Heart Failure [GWTG-HF] Registry). American Journal of Cardiology 121(4): 450-454, 2018

Valsartan reduces the incidence of atrial fibrillation in patients with heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT). American Heart Journal 149(3): 548-557, 2005

Valsartan Reduces the Incidence of Atrial Fibrillation in Patients With Heart Failure: Results From the Valsartan Heart Failure Trial (Val-HeFT). Yearbook of Cardiology 2006: 420-421, 2006

Impact of female gender on incidence and prognosis of infarction associated heart failure the worcester heart attack trial. Journal of the American College of Cardiology 15(2 SUPPL A): 168A, 1990

Recurrent Heart Failure in Patients With Atrial Fibrillation: Comorbidities, Comparison of Patients With Heart Failure Once to Those With Heart Failure Two or More Times. Chest Journal 144(4): 164a-164b, 2013

Twenty-year community-wide trends in the incidence and in-hosptial case-fatality rates associated with congestive heart failure complicating acute myocardial infarction The Worcester heart attack study. Journal of the American College of Cardiology 31(2 SUPPL A): 304A, 1998