Cardiovascular Disease |

Recurrent Heart Failure in Patients With Atrial Fibrillation: Comorbidities, Comparison of Patients With Heart Failure Once to Those With Heart Failure Two or More Times FREE TO VIEW

Nobuyki Anzai, MD; Hiroko Anzai, MD; Rieko Mitobe, MD; Makiko Anzai, MD; Kei Goto, MN
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Anzai-Furuya Clinic, Oyam, Japan

Chest. 2013;144(4_MeetingAbstracts):164A. doi:10.1378/chest.1681318
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SESSION TITLE: Cardiovascular Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Little is known about comorbidities in atrial fibrillation(AF) patients with recurrent heart failure(HF).

METHODS: Among 201 AF patients , who visited our outpatient between January 2012 and December 2012, 76/201(37.5%) had a history of HF at least once or more. HF occurred once, and twice or more in 41/201(20.4%) and 35/201(17.4%), respectively. To assess comorbidities in AF patients with recurrent HF. we investigated diffeferences on demographic characteristics, clinical manifestations and labloratory results between two groups.

RESULTS: Patients with HF twice or more: mean age: 81.9(SD 6.7 ,95% confidence index(CI) 79.6~81.2), female:11/35(31.9%), mean follow-up duration: 6.6(SD 3.4) years, 40.0% patient-year rate of HF. living alone: 17/34(54.3%), high school graduation or higher; 26/34(76.5%), cognition: 3/35(8.6%), NYHA classification(NYHA): 2.7(SD 0.8), ischemic heart disease(IHD):21/35(60.0%), cardiomyopathy: 2/35(5.7%), dilated left atrium(LA): 27/35(77.1%), chronic lung disease: 3/35(77.1%), hypertension:27/35(77.1%), diabetes mellitus(DM):12/35(34.3%), stroke: 9/35(25.7%), mean CHADS2 score(CHADS2): 3.3(SD 1.4, 95% CI 2.8~3.8),mean estimated gromerular filtration ratio(ml/min/173 m2)(eGFR):46.9(SD18.3, 95% CI 40.1~53.2), mean Hb:gm/dl(Hb): 9.8(SD 1.8), mean ejection fraction(EF): 50.5%(SD 15.9), mean frequency of HF: 2.6(SD 0.7), mean frequency of comorbidity: 3.7(SD 1.4). Patients with HF once: mean age: 77.6(SD 8.6, 95% CI 74.5~80.0), female: 19/41(30.6%), mean follow-up duration:6.4(SD 3.6) years, 11.2% patient-year rate of HF, living alone: 7/41(17.1%), high school or higher: 32/41(78.4%), cognition:4/41(12.2%), mean NYHA: 1.6(SD 0.7), IHD: 10/41(24.9%), cardiomyopathy: 2/41(4.9%), dilated left LA: 35/41(85.4%), chronic lung disease: 1/41(2.4), hypertension: 20/41(48.8%), DM: 4/41(9.8%),stroke:4/41(9.8%), mean CHADS2: 2.1(SD 1.7, 95% CI 1.7~2.5), mean eGFR: 52.6(SD 17.7, 95% CI 53.7~64.9), mean Hb: 12.4(SD 1.7), mean EF: 69.4%(SD 13.7), mean frequency of comorbidity: 1.8(SD 1.3). Significant differences betwenn patients wih HF twice or more and those with HF once were seen, as follows:age (P=0.012), hypertension (P=0.029), DM (P=0.012), eGFR (P=0.001), frequency of comorbidity (P=0.001), EF (P=0.012),IHD (P=0.004), NYHA(P=0.001), stroke (P=0.047),CHADS2 (P=0.002), Hb (P=0.039).

CONCLUSIONS: Multiple comorbidities were observed in AF patients with recurrent HF.

CLINICAL IMPLICATIONS: Comprehensive care shoud be taken to prevent recurrent HF in AF patients.

DISCLOSURE: The following authors have nothing to disclose: Nobuyki Anzai, Hiroko Anzai, Rieko Mitobe, Makiko Anzai, Kei Goto

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