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Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study
BACKGROUND: Atrial flutter (AFL) has been identified to be equivalent to atrial fibrillation (AF) in terms of preventing ischemic stroke, although differences exist in atrial rate, substrate, and electrophysiological mechanisms. This study aimed to investigate differences in clinical outcomes betwee...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586326/ https://www.ncbi.nlm.nih.gov/pubmed/28733435 http://dx.doi.org/10.1161/JAHA.117.006406 |
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author | Lin, Yu‐Sheng Chen, Tien‐Hsing Chi, Ching‐Chi Lin, Ming‐Shyan Tung, Tao‐Hsin Liu, Chi‐Hung Chen, Yung‐Lung Chen, Mien‐Cheng |
author_facet | Lin, Yu‐Sheng Chen, Tien‐Hsing Chi, Ching‐Chi Lin, Ming‐Shyan Tung, Tao‐Hsin Liu, Chi‐Hung Chen, Yung‐Lung Chen, Mien‐Cheng |
author_sort | Lin, Yu‐Sheng |
collection | PubMed |
description | BACKGROUND: Atrial flutter (AFL) has been identified to be equivalent to atrial fibrillation (AF) in terms of preventing ischemic stroke, although differences exist in atrial rate, substrate, and electrophysiological mechanisms. This study aimed to investigate differences in clinical outcomes between nonvalvular AF and AFL. METHODS AND RESULTS: AF and AFL patients without any prescribed anticoagulation were enrolled from a 13‐year national cohort database. Under series exclusion criteria, ischemic stroke, heart failure hospitalization, and all‐cause mortality were compared between the groups in real‐world conditions and after propensity score matching. We identified 175 420 patients in the AF cohort and 6239 patients in the AFL cohort, and the prevalence of most comorbidities and frequency of medications were significantly higher in the AF group than the AFL group. In the real‐world setting the AF patients had higher incidence rates of ischemic stroke, heart failure hospitalization, and all‐cause mortality than the AFL patients (all P<0.001). After propensity score matching, the incidence rate of ischemic stroke in the AF cohort was 1.63‐fold higher than in the AFL cohort (P<0.001), the incidence rate of heart failure hospitalization in the AF cohort was 1.70‐fold higher than in the AFL cohort (P<0.001), and the incidence rate of all‐cause mortality in the AF cohort was 1.08‐fold higher than in the AFL cohort (P=0.002). CONCLUSIONS: There were differences between AF and AFL in comorbidities and prognosis with regard to ischemic stroke, heart failure hospitalization, and all‐cause mortality. |
format | Online Article Text |
id | pubmed-5586326 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55863262017-09-11 Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study Lin, Yu‐Sheng Chen, Tien‐Hsing Chi, Ching‐Chi Lin, Ming‐Shyan Tung, Tao‐Hsin Liu, Chi‐Hung Chen, Yung‐Lung Chen, Mien‐Cheng J Am Heart Assoc Original Research BACKGROUND: Atrial flutter (AFL) has been identified to be equivalent to atrial fibrillation (AF) in terms of preventing ischemic stroke, although differences exist in atrial rate, substrate, and electrophysiological mechanisms. This study aimed to investigate differences in clinical outcomes between nonvalvular AF and AFL. METHODS AND RESULTS: AF and AFL patients without any prescribed anticoagulation were enrolled from a 13‐year national cohort database. Under series exclusion criteria, ischemic stroke, heart failure hospitalization, and all‐cause mortality were compared between the groups in real‐world conditions and after propensity score matching. We identified 175 420 patients in the AF cohort and 6239 patients in the AFL cohort, and the prevalence of most comorbidities and frequency of medications were significantly higher in the AF group than the AFL group. In the real‐world setting the AF patients had higher incidence rates of ischemic stroke, heart failure hospitalization, and all‐cause mortality than the AFL patients (all P<0.001). After propensity score matching, the incidence rate of ischemic stroke in the AF cohort was 1.63‐fold higher than in the AFL cohort (P<0.001), the incidence rate of heart failure hospitalization in the AF cohort was 1.70‐fold higher than in the AFL cohort (P<0.001), and the incidence rate of all‐cause mortality in the AF cohort was 1.08‐fold higher than in the AFL cohort (P=0.002). CONCLUSIONS: There were differences between AF and AFL in comorbidities and prognosis with regard to ischemic stroke, heart failure hospitalization, and all‐cause mortality. John Wiley and Sons Inc. 2017-07-21 /pmc/articles/PMC5586326/ /pubmed/28733435 http://dx.doi.org/10.1161/JAHA.117.006406 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Lin, Yu‐Sheng Chen, Tien‐Hsing Chi, Ching‐Chi Lin, Ming‐Shyan Tung, Tao‐Hsin Liu, Chi‐Hung Chen, Yung‐Lung Chen, Mien‐Cheng Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study |
title | Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study |
title_full | Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study |
title_fullStr | Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study |
title_full_unstemmed | Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study |
title_short | Different Implications of Heart Failure, Ischemic Stroke, and Mortality Between Nonvalvular Atrial Fibrillation and Atrial Flutter—a View From a National Cohort Study |
title_sort | different implications of heart failure, ischemic stroke, and mortality between nonvalvular atrial fibrillation and atrial flutter—a view from a national cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586326/ https://www.ncbi.nlm.nih.gov/pubmed/28733435 http://dx.doi.org/10.1161/JAHA.117.006406 |
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