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    Recent Trends in the Incidence, Treatment, and Prognosis of Patients With Heart Failure and Atrial Fibrillation (the Worcester Heart Failure Study)

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    Authors
    McManus, David D.
    Saczynski, Jane S.
    Lessard, Darleen M.
    Kinno, Menhel
    Pidikiti, Rahul
    Esa, Nada
    Harrington, Josephine
    Goldberg, Robert J.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Department of Medicine, Division of Cardiovascular Medicine
    Department of Medicine, Division of Geriatric Medicine
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2013-05-15
    Keywords
    Atrial Fibrillation
    Cardiovascular Agents
    Heart Failure
    UMCCTS funding
    Cardiology
    Cardiovascular Diseases
    Epidemiology
    Health Services Research
    
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    Link to Full Text
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127486/
    Abstract
    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 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.
    Source

    Am J Cardiol. 2013 May 15;111(10):1460-5. doi: 10.1016/j.amjcard.2013.01.298. Link to article on publisher's site

    DOI
    10.1016/j.amjcard.2013.01.298
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46616
    PubMed ID
    23465093
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    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjcard.2013.01.298
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