Atrial Fibrillation and Mortality in Heart Failure: A Community Study
AM Chamberlain, MM Redfield, A Alonso... - Circulation: Heart ..., 2011 - Am Heart Assoc... Furthermore, the nature of the relationship between HF and AF can be seen in data from the
Framingham Heart Study. Of participants who developed both AF and HF during ... Page 15. The
Framingham Heart Study reported that later development of AF in HF ...
Background—Heart failure (HF) and atrial fibrillation (AF) share common risk factors and often coexist. The combination of HF and AF may carry a worse prognosis than either condition alone; however, the magnitude of this risk remains controversial and it is not known whether the timing of AF influences the risk of death.
Methods and Results—We determined the risk of all-cause mortality in relation to the presence of AF prior to or after HF diagnosis in a community-based cohort of persons diagnosed with HF between 1983 and 2006. Of 1664 individuals with HF, 553 had a prior history of AF and 384 developed AF after HF. Over a median follow-up of 4.0 years, 450 deaths occurred among persons with prior AF, 314 among those with AF after HF, and 572 among patients without AF. In fully-adjusted models, compared to patients without AF, those with AF prior to HF had a 29% increased risk of death, while those who developed AF after HF exhibited more than a 2-fold increased risk of death.
Conclusions—In the community, AF is frequent in the setting of HF and is associated with a large excess risk of death. The magnitude of this excess risk differs markedly according to the timing of AF, with AF developing after HF conferring the largest increased risk of death compared to HF patients without AF.
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