Atrial fibrillation and long-term prognosis in patients hospitalized for heart failure: results from heart failure survey in Israel (HFSIS).
OBJECTIVE
Atrial fibrillation (AF) and heart failure (HF) commonly coexist, and each adversely affects the other. The aim of the study was to prospectively evaluate the impact of AF and its subtypes on management, and early and long-term outcome of hospitalized HF patients.


RESULTS
Data were prospectively collected on HF patients hospitalized in all public hospitals in Israel as part of a national survey (HFSIS). Atrial fibrillation patients were subdivided into intermittent and chronic AF subgroups. During March-April 2003, we enrolled 4102 HF patients, of whom 1360 (33.2%) had AF [600 (44.1%) intermittent, 562 (41.3%) chronic]. Patients with AF were older (76.9 +/- 10.5 vs. 71.7 +/- 12.6 years, P = 0.0001), males, with preserved LV systolic function. Crude mortality rates for AF patients were progressively and consistently higher during hospitalization and during the 4-year follow-up period, especially in the chronic AF group (P = 0.0001). After covariate adjustment, AF was associated with increased 1-year mortality [HR 1.19, 95% CI (1.03-1.36)].


CONCLUSIONS
AF was present in a third of hospitalized HF patients, and identified a population with increased mortality risk, largely due to co-morbidities.
Shotan
Avraham
A
Heart Institute, Hillel Yaffe Medical Center, Hadera 38100, Israel. shotana@yahoo.com
Garty
Moshe
M
Blondhein
David S
DS
Meisel
Simcha R
SR
Lewis
Basil S
BS
Shochat
Michael
M
Grossman
Ehud
E
Porath
Avi
A
Boyko
Valentina
V
Zimlichman
Reuven
R
Caspi
Abraham
A
Gottlieb
Shmuel
S
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013923:Thromboembolism / Q000517:prevention & control; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality