Outcomes of Medicare Beneficiaries With Heart Failure and Atrial Fibrillation

被引：58

作者：

Khazanie, Prateeti ^{[1
,2
]}

Liang, Li ^{[1
]}

Qualls, Laura G. ^{[1
]}

Curtis, Lesley H. ^{[1
,2
]}

Fonarow, Gregg C. ^{[3
]}

Hammill, Bradley G. ^{[1
,4
]}

Hammill, Stephen C.

Heidenreich, Paul A. ^{[5
]}

Masoudi, Frederick A. ^{[6
]}

Hernandez, Adrian F. ^{[1
,2
]}

Piccini, Jonathan P. ^{[1
,2
]}

机构：

[1] Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA

[2] Duke Univ, Sch Med, Dept Med, Durham, NC 27706 USA

[3] Ahmanson UCLA Cardiomyopathy Ctr, Los Angeles, CA USA

[4] Mayo Clin, Rochester, MN USA

[5] Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA

[6] Univ Colorado, Aurora, CO USA

来源：

JACC-HEART FAILURE | 2014年 / 2卷 / 01期

基金：

美国医疗保健研究与质量局;

关键词：

atrial fibrillation; heart failure; Medicare; mortality outcome; assessment (health care); patient readmission; VENTRICULAR SYSTOLIC DYSFUNCTION; PROFILING HOSPITAL PERFORMANCE; OPTIMIZE-HF; MORTALITY; RISK; REGISTRY; STROKE; READMISSION; RIVAROXABAN; PROGRESSION;

D O I：

10.1016/j.jchf.2013.11.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study sought to examine the long-term outcomes of patients hospitalized with heart failure and atrial fibrillation. Background Atrial fibrillation is common among patients hospitalized with heart failure. Associations of pre-existing and new-onset atrial fibrillation with long-term outcomes are unclear. Methods We analyzed 27,829 heart failure admissions between 2006 and 2008 at 281 hospitals in the American Heart Association's Get With The Guidelines-Heart Failure program linked with Medicare claims. Patients were classified as having pre-existing, new-onset, or no atrial fibrillation. Cox proportional hazards models were used to identify factors that were independently associated with all-cause mortality, all-cause readmission, and readmission for heart failure, stroke, and other cardiovascular disease at 1 and 3 years. Results After multivariable adjustment, pre-existing atrial fibrillation was associated with greater 3-year risks of all-cause mortality (hazard ratio [HR]: 1.14 [99% confidence interval (CI): 1.08 to 1.20]), all-cause readmission (HR: 1.09 [99% CI: 1.05 to 1.14]), heart failure readmission (HR: 1.15 [99% CI: 1.08 to 1.21]), and stroke readmission (HR: 1.20 [99% CI: 1.01 to 1.41]), compared with no atrial fibrillation. There was also a greater hazard of mortality at 1 year among patients with new-onset atrial fibrillation (HR: 1.12 [99% CI: 1.01 to 1.24]). Compared with no atrial fibrillation, newonset atrial fibrillation was not associated with a greater risk of the readmission outcomes. Stroke readmission rates at 1 year were just as high for patients with preserved ejection fraction as for patients with reduced ejection fraction. Conclusions Both pre-existing and new-onset atrial fibrillation were associated with greater long-term mortality among older patients with heart failure. Pre-existing atrial fibrillation was associated with greater risk of readmission. (C) 2014 by the American College of Cardiology Foundation

引用

页码：41 / 48

页数：8

共 30 条

[1] Impact of atrial fibrillation on mortality and readmission in older adults hospitalized with heart failure [J].

Ahmed, A ;

Thornton, P ;

Perry, GJ ;

Allman, RM ;

DeLong, JF .

EUROPEAN JOURNAL OF HEART FAILURE, 2004, 6 (04) :421-426

[2] Comparison of Mortality and Morbidity in Patients With Atrial Fibrillation and Heart Failure With Preserved Versus Decreased Left Ventricular Ejection Fraction [J].

Badheka, Apurva O. ;

Rathod, Ankit ;

Kizilbash, Mohammad A. ;

Bhardwaj, Aditya ;

Ali, Omaima ;

Afonso, Luis ;

Jacob, Sony .

AMERICAN JOURNAL OF CARDIOLOGY, 2011, 108 (09) :1283-1288

[3] Accuracy of ICD-9-CM codes for identifying cardiovascular and stroke risk factors [J].

Birman-Deych, E ;

Waterman, AD ;

Yan, Y ;

Nilasena, DS ;

Radford, MJ ;

Gage, BF .

MEDICAL CARE, 2005, 43 (05) :480-485

[4]

CARSON PE, 1993, CIRCULATION, V87, P102

[5]

Curtis LH, 2007, CIRCULATION, V115, pE595

[6] Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: A retrospective analysis of the SOLVD trials [J].

Dries, DL ;

Exner, DV ;

Gersh, BJ ;

Domanski, MJ ;

Waclawiw, MA ;

Stevenson, LW .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 32 (03) :695-703

[7] Organized program to initiate lifesaving treatment in hospitalized patients with heart failure (OPTIMIZE-HF): Rationale and design [J].

Fonarow, GC ;

Abraham, WT ;

Albert, NM ;

Gattis, WA ;

Gheorghiade, M ;

Greenberg, B ;

O'Connor, CM ;

Yancy, CW ;

Young, J .

AMERICAN HEART JOURNAL, 2004, 148 (01) :43-51

[8] 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines 2006 WRITING COMMITTEE MEMBERS Developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society [J].

Fuster, Valentin ;

Ryden, Lars E. ;

Cannom, Davis S. ;

Crijns, Harry J. ;

Curtis, Anne B. ;

Ellenbogen, Kenneth A. ;

Halperin, Jonathan L. ;

Kay, G. Neal ;

Le Huezey, Jean-Yves ;

Lowe, James E. ;

Olsson, S. Bertil ;

Prystowsky, Eric N. ;

Tamargo, Juan Luis ;

Wann, L. Samuel ;

Estes, N. A. Mark, III ;

Ezekowitz, Michael D. ;

Jackman, Warren M. ;

January, Craig T. ;

Page, Richard L. ;

Slotwiner, David J. ;

Stevenson, William G. ;

Tracy, Cynthia M. ;

Jacobs, Alice K. ;

Anderson, Jeffrey L. ;

Albert, Nancy ;

Buller, Christopher E. ;

Creager, Mark A. ;

Ettinger, Steven M. ;

Guyton, Robert A. ;

Hochman, Judith S. ;

Kushner, Frederick G. ;

Ohman, Erik Magnus ;

Tarkington, Lynn G. ;

Yancy, Clyde W. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 57 (11) :E101-E198

[9] A CLASS OF K-SAMPLE TESTS FOR COMPARING THE CUMULATIVE INCIDENCE OF A COMPETING RISK [J].

GRAY, RJ .

ANNALS OF STATISTICS, 1988, 16 (03) :1141-1154

[10] Linking inpatient clinical registry data to Medicare claims data using indirect identifiers [J].

Hammill, Bradley G. ;

Hernandez, Adrian F. ;

Peterson, Eric D. ;

Fonarow, Gregg C. ;

Schulman, Kevin A. ;

Curtis, Lesley H. .

AMERICAN HEART JOURNAL, 2009, 157 (06) :995-1000

← 1 2 3 →