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Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure
OBJECTIVE: Prior work estimated excess death rates associated with atrial fibrillation (AF) in heart failure (HF) with hazard ratios (HR). The aim was to estimate the life-years lost after newly diagnosed AF in HF patients. METHODS: Among patients diagnosed with HF in 2008–2018 in the nationwide Dan...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166900/ https://www.ncbi.nlm.nih.gov/pubmed/35669233 http://dx.doi.org/10.2147/CLEP.S365706 |
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author | Vinter, Nicklas Cordsen, Pia Lip, Gregory Y H Benjamin, Emelia J Johnsen, Søren Paaske Frost, Lars Trinquart, Ludovic |
author_facet | Vinter, Nicklas Cordsen, Pia Lip, Gregory Y H Benjamin, Emelia J Johnsen, Søren Paaske Frost, Lars Trinquart, Ludovic |
author_sort | Vinter, Nicklas |
collection | PubMed |
description | OBJECTIVE: Prior work estimated excess death rates associated with atrial fibrillation (AF) in heart failure (HF) with hazard ratios (HR). The aim was to estimate the life-years lost after newly diagnosed AF in HF patients. METHODS: Among patients diagnosed with HF in 2008–2018 in the nationwide Danish Heart Failure Registry, we compared patients with incident AF to referents matched on age, sex, and time since HF. We estimated the marginal hazard ratio (HR) for death and marginal difference in restricted mean survival times (RMST) between AF cases and referents at 10 years after AF diagnosis. We adjusted for sex, age at AF diagnosis, clinical and lifestyle risk factors, and medications. RESULTS: Among 4463 AF cases and 17,792 referents (mean age 73.7 years, 29% women), the HR was 1.41 (95% CI 1.38; 1.44) but there was evidence of non-proportional hazards. The difference in RMST was −18.2 months (95% CI −16.8; −19.6) at 10 years after AF diagnosis. There were differences in life-years lost between patients diagnosed with AF >1 year and ≤1 year after HF (−25.7 months, 95% CI −23.7; −27.7 vs −10.4 months, 95% CI −8.2; −12.5, p < 0.001), women and men (−20.3 months, 95% CI −17.7; −21.9 vs −17.2 months, 95% CI −15.5; −19.0, p = 0.05), patients with low, medium, and high CHA(2)DS(2)-VASc (10.3 months, 95% CI −4.6; −16.1 vs −18.5 months, 95% CI −16.7; −20.4 vs 22.1, 95% CI −18.8; −22.3, p = 0.002). CONCLUSION: HF patients with incident AF lost on average 1.5 life-years over 10 years after AF. Life-years lost were larger among patients diagnosed with AF >1 year after HF, women, and patients with higher CHA(2)DS(2)-VASc. |
format | Online Article Text |
id | pubmed-9166900 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-91669002022-06-05 Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure Vinter, Nicklas Cordsen, Pia Lip, Gregory Y H Benjamin, Emelia J Johnsen, Søren Paaske Frost, Lars Trinquart, Ludovic Clin Epidemiol Original Research OBJECTIVE: Prior work estimated excess death rates associated with atrial fibrillation (AF) in heart failure (HF) with hazard ratios (HR). The aim was to estimate the life-years lost after newly diagnosed AF in HF patients. METHODS: Among patients diagnosed with HF in 2008–2018 in the nationwide Danish Heart Failure Registry, we compared patients with incident AF to referents matched on age, sex, and time since HF. We estimated the marginal hazard ratio (HR) for death and marginal difference in restricted mean survival times (RMST) between AF cases and referents at 10 years after AF diagnosis. We adjusted for sex, age at AF diagnosis, clinical and lifestyle risk factors, and medications. RESULTS: Among 4463 AF cases and 17,792 referents (mean age 73.7 years, 29% women), the HR was 1.41 (95% CI 1.38; 1.44) but there was evidence of non-proportional hazards. The difference in RMST was −18.2 months (95% CI −16.8; −19.6) at 10 years after AF diagnosis. There were differences in life-years lost between patients diagnosed with AF >1 year and ≤1 year after HF (−25.7 months, 95% CI −23.7; −27.7 vs −10.4 months, 95% CI −8.2; −12.5, p < 0.001), women and men (−20.3 months, 95% CI −17.7; −21.9 vs −17.2 months, 95% CI −15.5; −19.0, p = 0.05), patients with low, medium, and high CHA(2)DS(2)-VASc (10.3 months, 95% CI −4.6; −16.1 vs −18.5 months, 95% CI −16.7; −20.4 vs 22.1, 95% CI −18.8; −22.3, p = 0.002). CONCLUSION: HF patients with incident AF lost on average 1.5 life-years over 10 years after AF. Life-years lost were larger among patients diagnosed with AF >1 year after HF, women, and patients with higher CHA(2)DS(2)-VASc. Dove 2022-05-31 /pmc/articles/PMC9166900/ /pubmed/35669233 http://dx.doi.org/10.2147/CLEP.S365706 Text en © 2022 Vinter et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Vinter, Nicklas Cordsen, Pia Lip, Gregory Y H Benjamin, Emelia J Johnsen, Søren Paaske Frost, Lars Trinquart, Ludovic Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure |
title | Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure |
title_full | Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure |
title_fullStr | Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure |
title_full_unstemmed | Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure |
title_short | Life-Years Lost After Newly Diagnosed Atrial Fibrillation in Patients with Heart Failure |
title_sort | life-years lost after newly diagnosed atrial fibrillation in patients with heart failure |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166900/ https://www.ncbi.nlm.nih.gov/pubmed/35669233 http://dx.doi.org/10.2147/CLEP.S365706 |
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