HF after discharge for AF elevates mortality risk
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Among patients discharged after hospitalization for atrial fibrillation, those subsequently hospitalized with HF had increased risk for all-cause death, according to a study published in Heart.
“The clinical predictors of incident HF emphasize the importance of integrated management of common comorbid conditions and lifestyle risk factors in patients with AF to reduce their morbidity and mortality,” the researchers wrote.
In a longitudinal cohort study, researchers analyzed 52,447 patients (median age, 73 years; 58% men) who were hospitalized with AF (88.9% for the first time).
Researchers found that 3 years after AF discharge, the cumulative incidence of HF was 11.7% (95% CI, 11.5-12) and the rate of all-cause death was 18.5% (95% CI, 18.2-18.8).
The crude rate of mortality was 6.9 per 100 person-years, and was higher in women than in men (7.4 per 100 person-years vs. 6.5 per 100 person-years), according to the researchers.
After multivariable adjustment, female sex, older age, prior MI, peripheral vascular disease, valvular heart disease, chronic kidney disease, hypertension, diabetes, obesity and excessive alcohol use independently predicted incident HF, and prior coronary revascularization was a negative predictor (P for all < .05).
At 3 years, patients hospitalized for first-ever HF compared with those without HF hospitalization had a threefold elevated risk for mortality (adjusted HR = 3.3; 95% CI, 3.1-3.4; P < .001), according to the researchers.
“The study supports HF risk stratification and prevention as an important management priority for patients diagnosed with AF. Reducing the incidence of HF will likely have a major impact on the morbidity, mortality and health care burden of AF,” the researchers wrote.
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