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Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure

Background: The prognostic impact and predictors of NOAF in HF patients are not fully elucidated. This study aims to determine whether new-onset atrial fibrillation (NOAF) affects patient outcome and investigate predictors of atrial fibrillation (AF) in acute heart failure (HF) patients using real-w...

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Autores principales: Choi, Hyo-In, Lee, Sang Eun, Kim, Min-Seok, Lee, Hae-Young, Cho, Hyun-Jai, Choi, Jin Oh, Jeon, Eun-Seok, Hwang, Kyung-Kuk, Chae, Shung Chull, Baek, Sang Hong, Kang, Seok-Min, Choi, Dong-Ju, Yoo, Byung-Su, Kim, Kye Hun, Cho, Myeong-Chan, Oh, Byung-Hee, Kim, Jae-Joong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025044/
https://www.ncbi.nlm.nih.gov/pubmed/35455070
http://dx.doi.org/10.3390/life12040579
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author Choi, Hyo-In
Lee, Sang Eun
Kim, Min-Seok
Lee, Hae-Young
Cho, Hyun-Jai
Choi, Jin Oh
Jeon, Eun-Seok
Hwang, Kyung-Kuk
Chae, Shung Chull
Baek, Sang Hong
Kang, Seok-Min
Choi, Dong-Ju
Yoo, Byung-Su
Kim, Kye Hun
Cho, Myeong-Chan
Oh, Byung-Hee
Kim, Jae-Joong
author_facet Choi, Hyo-In
Lee, Sang Eun
Kim, Min-Seok
Lee, Hae-Young
Cho, Hyun-Jai
Choi, Jin Oh
Jeon, Eun-Seok
Hwang, Kyung-Kuk
Chae, Shung Chull
Baek, Sang Hong
Kang, Seok-Min
Choi, Dong-Ju
Yoo, Byung-Su
Kim, Kye Hun
Cho, Myeong-Chan
Oh, Byung-Hee
Kim, Jae-Joong
author_sort Choi, Hyo-In
collection PubMed
description Background: The prognostic impact and predictors of NOAF in HF patients are not fully elucidated. This study aims to determine whether new-onset atrial fibrillation (NOAF) affects patient outcome and investigate predictors of atrial fibrillation (AF) in acute heart failure (HF) patients using real-world data. Methods: The factors associated with NOAF in 2894 patients with sinus rhythm (SR) enrolled in the Korean Acute Heart Failure (KorAHF) registry were investigated. Survival was analyzed using AF as a time-dependent covariate. Relevant predictors of NOAF were analyzed using multivariate proportional hazards models. Results: Over 27.4 months, 187 patients developed AF. The median overall survival time was over 48 and 9.9 months for the SR and NOAF groups, respectively. Cox regression analysis with NOAF as a time-dependent covariate showed a higher risk of death among patients with NOAF. Multivariate Cox modeling showed that age, worsening HF, valvular heart disease (VHD), loop diuretics, lower heart rate, larger left atrium (LA) diameter, and elevated creatinine levels were independently associated with NOAF. Risk score indicated the number of independent predictors. The incidence of NOAF was 2.9%, 9.4%, and 21.8% in the low-risk, moderate-risk, and high-risk groups, respectively (p < 0.001). Conditional inference tree analysis identified worsening HF, heart rate, age, LA diameter, and VHD as discriminators. Conclusions: NOAF was associated with decreased survival in acute HF patients with SR. Age, worsening HF, VHD, loop diuretics, lower heart rate, larger LA diameter, and elevated creatinine could independently predict NOAF. This may be useful to risk-stratify HF patients at risk for AF.
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spelling pubmed-90250442022-04-23 Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure Choi, Hyo-In Lee, Sang Eun Kim, Min-Seok Lee, Hae-Young Cho, Hyun-Jai Choi, Jin Oh Jeon, Eun-Seok Hwang, Kyung-Kuk Chae, Shung Chull Baek, Sang Hong Kang, Seok-Min Choi, Dong-Ju Yoo, Byung-Su Kim, Kye Hun Cho, Myeong-Chan Oh, Byung-Hee Kim, Jae-Joong Life (Basel) Article Background: The prognostic impact and predictors of NOAF in HF patients are not fully elucidated. This study aims to determine whether new-onset atrial fibrillation (NOAF) affects patient outcome and investigate predictors of atrial fibrillation (AF) in acute heart failure (HF) patients using real-world data. Methods: The factors associated with NOAF in 2894 patients with sinus rhythm (SR) enrolled in the Korean Acute Heart Failure (KorAHF) registry were investigated. Survival was analyzed using AF as a time-dependent covariate. Relevant predictors of NOAF were analyzed using multivariate proportional hazards models. Results: Over 27.4 months, 187 patients developed AF. The median overall survival time was over 48 and 9.9 months for the SR and NOAF groups, respectively. Cox regression analysis with NOAF as a time-dependent covariate showed a higher risk of death among patients with NOAF. Multivariate Cox modeling showed that age, worsening HF, valvular heart disease (VHD), loop diuretics, lower heart rate, larger left atrium (LA) diameter, and elevated creatinine levels were independently associated with NOAF. Risk score indicated the number of independent predictors. The incidence of NOAF was 2.9%, 9.4%, and 21.8% in the low-risk, moderate-risk, and high-risk groups, respectively (p < 0.001). Conditional inference tree analysis identified worsening HF, heart rate, age, LA diameter, and VHD as discriminators. Conclusions: NOAF was associated with decreased survival in acute HF patients with SR. Age, worsening HF, VHD, loop diuretics, lower heart rate, larger LA diameter, and elevated creatinine could independently predict NOAF. This may be useful to risk-stratify HF patients at risk for AF. MDPI 2022-04-13 /pmc/articles/PMC9025044/ /pubmed/35455070 http://dx.doi.org/10.3390/life12040579 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Choi, Hyo-In
Lee, Sang Eun
Kim, Min-Seok
Lee, Hae-Young
Cho, Hyun-Jai
Choi, Jin Oh
Jeon, Eun-Seok
Hwang, Kyung-Kuk
Chae, Shung Chull
Baek, Sang Hong
Kang, Seok-Min
Choi, Dong-Ju
Yoo, Byung-Su
Kim, Kye Hun
Cho, Myeong-Chan
Oh, Byung-Hee
Kim, Jae-Joong
Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure
title Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure
title_full Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure
title_fullStr Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure
title_full_unstemmed Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure
title_short Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure
title_sort prognostic impact and predictors of new-onset atrial fibrillation in heart failure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025044/
https://www.ncbi.nlm.nih.gov/pubmed/35455070
http://dx.doi.org/10.3390/life12040579
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