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European Journal of Heart Failure 2005 7(7):1118-1121; doi:10.1016/j.ejheart.2004.12.004
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© 2005 European Society of Cardiology

Incident atrial fibrillation and mortality in older adults with heart failure

Ali Ahmeda,b,c,* and Gilbert J. Perryd,e

a Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Medicine Birmingham, AL, United States
b Department of Epidemiology, School of Public Health, University of Alabama at Birmingham Birmingham, AL, United States
c Section of Geriatrics, Veterans Affairs Medical Center, Birmingham AL, Birmingham, AL, United States
d Division of Cardiovascular Disease, Department of Medicine, School of Medicine Birmingham, AL, United States
e Section of Cardiology, Veterans Affairs Medical Center Birmingham, AL, United States

* Corresponding author. UAB Center for Aging, 1530 3rd Ave South, CH-19, Ste-219, Birmingham, AL 35294-2041, United States. Tel.: +1 205 934 9632; fax: +1 205 975 7099. E-mail address: aahmed{at}uab.edu


  Abstract

We studied 944 hospitalized heart failure patients 65 years and older to examine the impact of incident atrial fibrillation on mortality. Patients were categorized into four groups based on past medical history and admission electrocardiogram: (1) no (neither past nor current), (2) incident (newly diagnosed), (3) past and (4) chronic (past and current) atrial fibrillation. The primary outcome was 4-year all-cause mortality. Bivariate and multivariable Cox proportion hazards analyses were used to determine risk of all-cause mortality. In the multivariable model, we adjusted for various demographic and clinical covariates. Compared with patients who never had atrial fibrillation, those with incident atrial fibrillation had a 57% higher risk of death (unadjusted hazard ratio, 1.57; 95% confidence interval, 1.22–2.03). After adjustment for other covariates the association remained unchanged (adjusted hazard ratio, 1.41; 95% confidence interval, 1.08–1.83). Past or chronic atrial fibrillation was not associated with increased risk of death.

Key Words: Incident atrial fibrillation • Mortality • Heart failure

Received September 27, 2004; Revised November 12, 2004; Accepted December 20, 2004


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