Aims The purpose of this study was too describe the associated baseline features of AF patients with heart failure (HF) with reduced and preserved ejection fraction (HFrEF and HFpEF). Secondly, we assessed symptomatic status and their clinical correlates. Finally, we examined independent predictors for 'heart failure' at the 1-year follow-up period. Methods and results A survey of European cardiologists from nine countries, participating in the EURObservational Research Programme Pilot survey on Atrial Fibrillation (EORP-AF Pilot), was carried out. Of the whole cohort of 2972 patients, 1411 (47.5%) had a diagnosis of HF. Of the AF patients with HF, oral anticoagulants were prescribed to 82.1% and antiarrhythmic drugs in 36.7%. Independent predictors of HFpEF were high body mass index, high heart rate, high systolic blood pressure, low diastolic blood pressure, high CHA2DS2-VASc score, and absence of chronic kidney disease, sleep apnoea, or ischaemic cardiomyopathy. On multivariate stepwise regression analysis, independent predictors of the development of HF were mode of AF presentation, diuretic use, prior HF, COPD, and valvular disease. At 1 year, HF was associated with a greater risk of all-cause mortality (log-rank test, P < 0.001). When HFrEF was compared with HFpEF at 1 year, crude rates were significant for the composite endpoint of 'stroke/thrombo-embolism/transient ischaemic attack and death' (15.9% vs. 11.1%, P = 0.043). Conclusion We provide insights into the clinical characteristics and outcomes in AF patients with HF, who were managed by European cardiologists. Despite a high prevalence of oral anticoagulant use, 1-year mortality and morbidity remained high in AF patients with HF, whether HFrEF or HFpEF. Such patients require a holistic approach to cardiovascular risk management.

Heart failure in patients with atrial fibrillation in Europe: A report from the EURObservational Research Programme Pilot survey on Atrial Fibrillation / Lip, Gregory Y. H; Laroche, Cécile; Popescu, Mircea I.; Rasmussen, Lars H.; Vitali Serdoz, Laura; Dan, Gheorghe Andrei; Kalarus, Zbigniew; Crijns, Harry J. G. M.; Oliveira, Mario M.; Tavazzi, Luigi; Maggioni, Aldo P.; Boriani, Giuseppe. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 17:6(2015), pp. 570-582. [10.1002/ejhf.254]

Heart failure in patients with atrial fibrillation in Europe: A report from the EURObservational Research Programme Pilot survey on Atrial Fibrillation

BORIANI, Giuseppe
2015

Abstract

Aims The purpose of this study was too describe the associated baseline features of AF patients with heart failure (HF) with reduced and preserved ejection fraction (HFrEF and HFpEF). Secondly, we assessed symptomatic status and their clinical correlates. Finally, we examined independent predictors for 'heart failure' at the 1-year follow-up period. Methods and results A survey of European cardiologists from nine countries, participating in the EURObservational Research Programme Pilot survey on Atrial Fibrillation (EORP-AF Pilot), was carried out. Of the whole cohort of 2972 patients, 1411 (47.5%) had a diagnosis of HF. Of the AF patients with HF, oral anticoagulants were prescribed to 82.1% and antiarrhythmic drugs in 36.7%. Independent predictors of HFpEF were high body mass index, high heart rate, high systolic blood pressure, low diastolic blood pressure, high CHA2DS2-VASc score, and absence of chronic kidney disease, sleep apnoea, or ischaemic cardiomyopathy. On multivariate stepwise regression analysis, independent predictors of the development of HF were mode of AF presentation, diuretic use, prior HF, COPD, and valvular disease. At 1 year, HF was associated with a greater risk of all-cause mortality (log-rank test, P < 0.001). When HFrEF was compared with HFpEF at 1 year, crude rates were significant for the composite endpoint of 'stroke/thrombo-embolism/transient ischaemic attack and death' (15.9% vs. 11.1%, P = 0.043). Conclusion We provide insights into the clinical characteristics and outcomes in AF patients with HF, who were managed by European cardiologists. Despite a high prevalence of oral anticoagulant use, 1-year mortality and morbidity remained high in AF patients with HF, whether HFrEF or HFpEF. Such patients require a holistic approach to cardiovascular risk management.
2015
2-mar-2015
17
6
570
582
Heart failure in patients with atrial fibrillation in Europe: A report from the EURObservational Research Programme Pilot survey on Atrial Fibrillation / Lip, Gregory Y. H; Laroche, Cécile; Popescu, Mircea I.; Rasmussen, Lars H.; Vitali Serdoz, Laura; Dan, Gheorghe Andrei; Kalarus, Zbigniew; Crijns, Harry J. G. M.; Oliveira, Mario M.; Tavazzi, Luigi; Maggioni, Aldo P.; Boriani, Giuseppe. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 17:6(2015), pp. 570-582. [10.1002/ejhf.254]
Lip, Gregory Y. H; Laroche, Cécile; Popescu, Mircea I.; Rasmussen, Lars H.; Vitali Serdoz, Laura; Dan, Gheorghe Andrei; Kalarus, Zbigniew; Crijns, Har...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1139637
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