title: Role of permanent atrial fibrillation (AF) on long-term mortality in community-dwelling elderly people with and without chronic heart failure (CHF).
abstract: Permanent AF is characterized by an increased mortality in elderly subjects with CHF. Moreover, AF increased the risk of mortality also in elderly subjects without CHF. Thus, we examined long-term mortality in community-dwelling elderly people with and without CHF. A total of 1332 subjects aged 65 and older were selected from the electoral rolls of Campania, a region of southern Italy. The relationship between AF and mortality during a 12-year follow-up in 125 subjects with CHF and in 1.143 subjects without CHF were studied. Elderly subjects showed a higher mortality in those with respect to those without AF (72.1% vs. 51.8%; p<0.01). Similarly, elderly subjects without CHF showed a higher mortality in those with respect to those without AF (61.8% vs. 49.8%; p<0.05). In contrast, elderly subjects with CHF showed a similar mortality in those with respect to those without AF (74.7% vs. 82.4%; p=0.234). Multivariate analysis shows that AF was predictive of mortality in all elderly subjects (Hazard Risk=HR=1.39, 95% confidence interval (CI)=1.25-2.82; p<0.001). When the analysis was conducted considering the presence and the absence of CHF, AF was strongly predictive of mortality in elderly subjects without CHF (HR=1.95, 95%CI=1.25-4.51; p<0.001) but not in those with CHF (HR=1.12, 95%CI=0.97-3.69; p=0.321). We concluded that AF is able to predict long-term mortality in elderly subjects. Moreover, AF is strongly predictive of long-term mortality in the absence but not in the presence of CHF.
authors: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Cattedra di Geriatria, Università di Napoli Federico II, Via S. Pansini, 5, I-80131 Napoli, Italy.
authors: Gianluca
authors: G
authors: Testa
authors: Francesco
authors: F
authors: Cacciatore
authors: David
authors: D
authors: Della-Morte
authors: Gianluigi
authors: G
authors: Galizia
authors: Francesca
authors: F
authors: Mazzella
authors: Gaetano
authors: G
authors: Gargiulo
authors: Assunta
authors: A
authors: Langellotto
authors: Daniele
authors: D
authors: D'Ambrosio
authors: Nicola
authors: N
authors: Ferrara
authors: Franco
authors: F
authors: Rengo
authors: Pasquale
authors: P
authors: Abete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000401:mortality*; D002423:Cause of Death; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012720:Severity of Illness Index