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    Risk assessment for incident heart failure in individuals with atrial fibrillation

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    Authors
    Schnabel, Renate B.
    Rienstra, Michiel
    Sullivan, Lisa M.
    Sun, Jenny X.
    Moser, Carlee B.
    Levy, Daniel
    Pencina, Michael J.
    Fontes, Joao D.
    Magnani, Jared W.
    McManus, David D.
    Lubitz, Steven A.
    Tadros, Thomas M.
    Eang, Thomas J.
    Ellinor, Patrick T.
    Vasan, Ramachandran S.
    Benjamin, Emelia J.
    Show allShow less
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2013-08-01
    Keywords
    Atrial Fibrillation
    Incidence
    Heart Failure
    UMCCTS funding
    Cardiology
    Cardiovascular Diseases
    Clinical Epidemiology
    Epidemiology
    Health Services Research
    
    Metadata
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    Link to Full Text
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858114/
    Abstract
    BACKGROUND: Atrial fibrillation (AF) is a strong risk factor for heart failure (HF); HF onset in patients with AF is associated with increased morbidity and mortality. Risk factors that predict HF in individuals with AF in the community are not well established. METHODS AND RESULTS: We examined clinical variables related to the 10-year incidence of HF in 725 individuals (mean 73.3 years, 45% women) with documented AF in the Framingham Heart Study. Event rates for incident HF (n = 161, 48% in women) were comparable in women (4.30 per 100 person-years) and men (3.34 per 100 person-years). Age, body mass index, ECG LV hypertrophy, diabetes, significant murmur, and history of myocardial infarction were positively associated with incident HF in multivariable models (C-statistic 0.71; 95% confidence interval 0.67-0.75). We developed a risk algorithm for estimating absolute risk of HF in AF patients with good model fit and calibration (adjusted calibration chi2 statistic 7.29; Pchi2 = 0.61). Applying the algorithm, 47.6% of HF events occurred in the top tertile in men compared with 13.1% in the bottom tertile, and 58.4% in women in the upper tertile compared with 18.2% in the lowest category. For HF type, women had a non-significantly higher incidence of HF with preserved EF compared with men. CONCLUSIONS: We describe advancing age, LV hypertrophy, body mass index, diabetes, significant heart murmur, and history of myocardial infarction as clinical predictors of incident HF in individuals with AF. A risk algorithm may help identify individuals with AF at high risk of developing HF.
    Source

    Schnabel RB, Rienstra M, Sullivan LM, Sun JX, Moser CB, Levy D, Pencina MJ, Fontes JD, Magnani JW, McManus DD, Lubitz SA, Tadros TM, Wang TJ, Ellinor PT, Vasan RS, Benjamin EJ. Risk assessment for incident heart failure in individuals with atrial fibrillation. Eur J Heart Fail. 2013 Aug;15(8):843-9. doi:10.1093/eurjhf/hft041. Link to article on publisher's site

    DOI
    10.1093/eurjhf/hft041
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37237
    PubMed ID
    23594831
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1093/eurjhf/hft041
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