Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure

被引:3
作者
Choi, Hyo-In [1 ]
Lee, Sang Eun [2 ]
Kim, Min-Seok [2 ]
Lee, Hae-Young [3 ]
Cho, Hyun-Jai [3 ]
Choi, Jin Oh [4 ]
Jeon, Eun-Seok [4 ]
Hwang, Kyung-Kuk [5 ]
Chae, Shung Chull [6 ]
Baek, Sang Hong [7 ]
Kang, Seok-Min [8 ]
Choi, Dong-Ju [9 ]
Yoo, Byung-Su [10 ]
Kim, Kye Hun [11 ]
Cho, Myeong-Chan [5 ]
Oh, Byung-Hee [3 ]
Kim, Jae-Joong [2 ]
机构
[1] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Cardiol,Sch Med, Seoul 03181, South Korea
[2] Univ Ulsan, Asan Med Ctr, Dept Internal Med, Div Cardiol,Coll Med, Seoul 05505, South Korea
[3] Seoul Natl Univ Hosp, Dept Internal Med, Div Cardiol, Seoul 03080, South Korea
[4] Sungkyunkwan Univ, Dept Internal Med, Div Cardiol, Coll Med, Seoul 06351, South Korea
[5] Chungbuk Natl Univ, Dept Internal Med, Div Cardiol, Coll Med, Cheongju 28644, South Korea
[6] Kyungpook Natl Univ, Dept Internal Med, Div Cardiol, Coll Med, Daegu 41944, South Korea
[7] Catholic Univ Republ Korea, Dept Internal Med, Div Cardiol, Seoul 03083, South Korea
[8] Yonsei Univ, Dept Internal Med, Div Cardiol, Coll Med, Seoul 03722, South Korea
[9] Seoul Natl Univ, Bundang Hosp, Div Cardiol, Cardiovasc Ctr, Seongnam 13620, South Korea
[10] Yonsei Univ, Dept Internal Med, Wonju Coll Med, Div Cardiol, Wonju 26426, South Korea
[11] Chonnam Natl Univ, Heart Res Ctr, Gwangju 61469, South Korea
来源
LIFE-BASEL | 2022年 / 12卷 / 04期
关键词
atrial fibrillation; heart failure; mortality; risk factors; registries; RISK;
D O I
10.3390/life12040579
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: The prognostic impact and predictors of NOAF in HF patients are not fully elucidated. This study aims to determine whether new-onset atrial fibrillation (NOAF) affects patient outcome and investigate predictors of atrial fibrillation (AF) in acute heart failure (HF) patients using real-world data. Methods: The factors associated with NOAF in 2894 patients with sinus rhythm (SR) enrolled in the Korean Acute Heart Failure (KorAHF) registry were investigated. Survival was analyzed using AF as a time-dependent covariate. Relevant predictors of NOAF were analyzed using multivariate proportional hazards models. Results: Over 27.4 months, 187 patients developed AF. The median overall survival time was over 48 and 9.9 months for the SR and NOAF groups, respectively. Cox regression analysis with NOAF as a time-dependent covariate showed a higher risk of death among patients with NOAF. Multivariate Cox modeling showed that age, worsening HF, valvular heart disease (VHD), loop diuretics, lower heart rate, larger left atrium (LA) diameter, and elevated creatinine levels were independently associated with NOAF. Risk score indicated the number of independent predictors. The incidence of NOAF was 2.9%, 9.4%, and 21.8% in the low-risk, moderate-risk, and high-risk groups, respectively (p < 0.001). Conditional inference tree analysis identified worsening HF, heart rate, age, LA diameter, and VHD as discriminators. Conclusions: NOAF was associated with decreased survival in acute HF patients with SR. Age, worsening HF, VHD, loop diuretics, lower heart rate, larger LA diameter, and elevated creatinine could independently predict NOAF. This may be useful to risk-stratify HF patients at risk for AF.
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页数:12
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