Atrial Fibrillation and Cardiovascular Outcomes in the Elderly

O’Neal, Wesley T.; Salahuddin, Taufiq; Broughton, Stephen T; Soliman, Elsayed Z.

doi:10.1111/pace.12907

Cited by 24 publications

(24 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Beta‐blockers, especially beta‐1‐selective beta‐blockers, but also non‐selective beta‐blockers among men, were associated with a lower risk of incident CHF, but also in general with a lower mortality risk in heart diseases supporting our findings on CHF, as CHF is a great contributor to mortality in AF 7 . Studies on beta‐blockers in hypertension and the risk of CHF have shown conflicting results, with one review finding no positive effect, 12 and another a preventive effect 16 .…”

Section: Discussionsupporting

confidence: 83%

“…Even if ischemic stroke is the most well‐known disease associated with AF, 5,6 congestive heart failure (CHF) is also of great importance and is three times more common in AF patients compared with non‐AF patients 7 . CHF and AF are interrelated diseases 8,9 with one that could precede the other.…”

Section: Introductionmentioning

confidence: 99%

“…CHF and AF are interrelated diseases 8,9 with one that could precede the other. Both stroke 10 and CHF 7 are significant contributors to mortality in patients with AF.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation

Wändell

Carlsson

et al. 2020

J of Clinical Hypertension

View full text Add to dashboard Cite

Congestive heart failure (CHF) is the most important cause of death in patients with atrial fibrillation (AF). We aimed to study the association between cardiovascular drugs in AF patients and incident CHF. The study population included all adults (n = 120 756) aged ≥45 years diagnosed with AF in Sweden diagnosed for the period 1998‐2006. Outcome was incident congestive heart failure (follow‐up 2007‐2015) in AF patients. Associations between treatment with cardiovascular pharmacotherapies and CHF were evaluated using Cox regression to estimate hazard ratios (HRs) with 95% CIs, after adjustment for age, sociodemographic variables, and comorbidities. During a mean 5.3 years (SD 3.0) of follow‐up, there were 28 257 (23.4%) incident cases of CHF. Treatment with beta‐1‐selective and non‐selective beta‐blockers and statins was associated with lower risks of incident CHF in men, HR, (95% CI); 0.90, (0.87‐0.94); 0.90, (0.84‐0.97), and 0.94, (0.90‐0.99), respectively. Only beta‐1‐selective beta‐blockers were protective in women 0.94 (0.91‐0.98). Treatment with loop diuretics, potassium‐saving agents, ACE inhibitors, and angiotensin receptor blockers was associated with a higher risk of CHF. For men, treatment with heart‐active calcium channel blockers also led to a higher risk of CHF. In conclusion, we found that beta‐blockers, in particular, but also statins were associated with lower risk of incident CHF in patients with AF.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation

Wändell

Carlsson

et al. 2020

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

“…Prior studies in the non-CKD population have also reported strong links between AF and HF. [6][7][8][9][10][11][12]44,45 Among participants in the Framingham study, AF was associated with a two-fold increased risk of incident HF, 46 and HF was the most common nonfatal CVD outcome after AF in Medicare beneficiaries. 14 Other studies in non-CKD cohorts have also noted an association between AF and risk of MI.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Events after New-Onset Atrial Fibrillation in Adults with CKD: Results from the Chronic Renal Insufficiency Cohort (CRIC) Study

Bansal

Xie

Sha

et al. 2018

JASN

Self Cite

View full text Add to dashboard Cite

Background Atrial fibrillation (AF), the most common sustained arrhythmia in CKD, is associated with poor clinical outcomes in both patients without CKD and patients with dialysis-treated ESRD. However, less is known about AF-associated outcomes in patients with CKD who do not require dialysis. Methods To prospectively examine the association of new-onset AF with subsequent risks of cardiovascular disease events and death among adults with CKD, we studied participants enrolled in the Chronic Renal Insufficiency Cohort Study who did not have AF at baseline. Outcomes included heart failure, myocardial infarction, stroke, and death occurring after diagnosis of AF. We used Cox regression models and marginal structural models to examine the association of incident AF with subsequent risk of cardiovascular disease events and death, adjusting for patient characteristics, laboratory values, and medication use. Results Among 3080 participants, 323 (10.5%) developed incident AF during a mean 6.1 years of follow-up. Compared with participants who did not develop AF, those who did had higher adjusted rates of heart failure (hazard ratio [HR], 5.17; 95% confidence interval [95% CI], 3.89 to 6.87), myocardial infarction (HR, 3.64; 95% CI, 2.50 to 5.31), stroke (HR, 2.66; 95% CI, 1.50 to 4.74), and death (HR, 3.30; 95% CI, 2.65 to 4.12). These associations remained robust with additional adjustment for biomarkers of inflammation, cardiac stress, and mineral metabolism; left ventricular mass; ejection fraction; and left atrial diameter. Conclusions Incident AF is independently associated with two-to five-fold increased rates of developing subsequent heart failure, myocardial infarction, stroke, or death in adults with CKD. These findings have important implications for cardiovascular risk reduction.

show abstract

“…As regards gout in relation to ischemic stroke, hyperuricemia is shown to increase the risk of ischemic stroke [15], and add to predictive value to the most common clinical risk predictor of ischemic stroke in AF, i.e., the CHA 2 DS 2 -VASc [16]. However, there are also other risks with AF, with congestive heart failure (CHF) being more common among patients with AF compared to individuals without AF [17], and CHF is the most common cause of death among patients with AF [18]. AF is also associated with development of dementia [19].…”

Section: Introductionmentioning

confidence: 99%

The Association Between Gout and Cardiovascular Disease in Patients with Atrial Fibrillation

Wändell

Carlsson

Sundquist

et al. 2019

SN Compr. Clin. Med.

View full text Add to dashboard Cite

Gout is a sign of a disturbed metabolism and associated with atrial fibrillation (AF) and other cardiovascular diseases. Our aim was to study associations between gout and cardiovascular comorbidities in patients with AF. The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF visiting 75 primary care centers in Sweden 2001-2007. Logistic regression was used to calculate odds ratios with 95% confidence intervals (CIs) for the associations between prevalent gout and cardiovascular comorbidities. In subsamples, we studied incident congestive heart failure (CHF) and ischemic stroke (IS), excluding patients with earlier registered specific diagnosis, using Cox regression (to estimate hazard ratios (HR) with 95% CIs). Gout was significantly and positively associated with CHF, obesity and diabetes among men and women, and among men also with hypertension and coronary heart disease. Prevalent gout was negatively associated with incident IS (HR and 95% CI: 0.64, 0.49-0.82; 0.50, 0.39-0.64) in both full model (adjusted for sex, age, socioeconomic factors, and comorbidities) and CHA 2 DS 2 -VASc model (adjusted for CHA 2 DS 2 -VASc, sex, and age). Adding gout to full model increased Harrell's C by 1% in CHA 2 DS 2 -VASc model. In this clinical setting, we found gout to be associated with most cardiometabolic diseases except cerebrovascular diseases, and with decreased risk of IS, with gout adding significantly to the predictive value compared to CHA 2 DS 2 -VASc without gout included.

show abstract

Atrial Fibrillation and Cardiovascular Outcomes in the Elderly

Abstract: AF is associated with several adverse cardiovascular outcomes and heart failure is the most frequently detected event. Potentially, risk factor modification strategies for the primary prevention of heart failure will reduce the morbidity and mortality associated with AF.

Cited by 24 publications

References 36 publications

Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation

Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation

Cardiovascular Events after New-Onset Atrial Fibrillation in Adults with CKD: Results from the Chronic Renal Insufficiency Cohort (CRIC) Study

The Association Between Gout and Cardiovascular Disease in Patients with Atrial Fibrillation

Contact Info

Product

Resources

About