The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure
Abstract Background To investigate the clinical implication of the temporal difference in atrial fibrillation (AF)‐onset in acute decompensated heart failure (ADHF) and its impact on post‐discharge prognosis. Methods 336 new‐onset ADHF patients without any history of AF before admission were enrolle...
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doaj-a84c7631ccdf4ac8ad1b96cd2ef4a3212020-11-25T03:42:58ZengWileyJournal of Arrhythmia1880-42761883-21482020-10-0136587488210.1002/joa3.12386The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failureMasashi Kamioka0Akiomi Yoshihisa1Minoru Nodera2Tomofumi Misaka3Tetsuro Yokokawa4Takashi Kaneshiro5Kazuhiko Nakazato6Takafumi Ishida7Yasuchika Takeishi8Department of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Advanced Cardiac Therapeutics Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Arrhythmia and Cardiac Pacing Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanDepartment of Cardiovascular Medicine Fukushima Medical University Fukushima JapanAbstract Background To investigate the clinical implication of the temporal difference in atrial fibrillation (AF)‐onset in acute decompensated heart failure (ADHF) and its impact on post‐discharge prognosis. Methods 336 new‐onset ADHF patients without any history of AF before admission were enrolled (201 males, 63 ± 16 year‐old) and classified into two groups based on their history of AF: the Control group (No AF was detected during hospitalization, n = 278), and the In‐hos‐AF group (AF occurred during hospitalization, n = 58). Post discharge prognosis including rehospitalization due to worsening HF, cardiac death, all‐cause death and cerebrovascular event were compared. Results Kaplan‐Meier analysis demonstrated that the incidence of rehospitalization due to HF, cardiac death, all‐cause death and cerebrovascular event in the In‐hos‐AF group was not significantly different from that in the Control group (P > 0.05 respectively). However, when AF recurred in the In‐hos‐AF group patients (n = 24, 41%) after discharge, the incidence of rehospitalization due to HF and cardiac deaths were higher than those without AF recurrence (P = 0.018 and P = 0.027 respectively). Cox proportional analysis revealed that AF developing after discharge was proven to be an independent risk factor for rehospitalization due to HF (HR 1.845, P = 0.043), cardiac death (HR 3.562, P = 0.013) and all‐cause deaths (HR 2.138, P = 0.020). Conclusion Clinical outcomes of new‐onset in‐hospital AF patients were as good as those without AF history until AF recurrence. However, AF recurrence led to worse prognosis. Therefore, treatment for new‐onset in‐hospital AF in ADHF patients might be postponed until AF recurrence.https://doi.org/10.1002/joa3.12386acute heart failureatrial fibrillation after dischargecardiac deathcerebrovascular eventnew‐onset in‐hospital atrial fibrillation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Masashi Kamioka Akiomi Yoshihisa Minoru Nodera Tomofumi Misaka Tetsuro Yokokawa Takashi Kaneshiro Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi |
spellingShingle |
Masashi Kamioka Akiomi Yoshihisa Minoru Nodera Tomofumi Misaka Tetsuro Yokokawa Takashi Kaneshiro Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure Journal of Arrhythmia acute heart failure atrial fibrillation after discharge cardiac death cerebrovascular event new‐onset in‐hospital atrial fibrillation |
author_facet |
Masashi Kamioka Akiomi Yoshihisa Minoru Nodera Tomofumi Misaka Tetsuro Yokokawa Takashi Kaneshiro Kazuhiko Nakazato Takafumi Ishida Yasuchika Takeishi |
author_sort |
Masashi Kamioka |
title |
The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure |
title_short |
The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure |
title_full |
The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure |
title_fullStr |
The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure |
title_full_unstemmed |
The clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure |
title_sort |
clinical implication of new‐onset in‐hospital atrial fibrillation in patients with acute decompensated heart failure |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 1883-2148 |
publishDate |
2020-10-01 |
description |
Abstract Background To investigate the clinical implication of the temporal difference in atrial fibrillation (AF)‐onset in acute decompensated heart failure (ADHF) and its impact on post‐discharge prognosis. Methods 336 new‐onset ADHF patients without any history of AF before admission were enrolled (201 males, 63 ± 16 year‐old) and classified into two groups based on their history of AF: the Control group (No AF was detected during hospitalization, n = 278), and the In‐hos‐AF group (AF occurred during hospitalization, n = 58). Post discharge prognosis including rehospitalization due to worsening HF, cardiac death, all‐cause death and cerebrovascular event were compared. Results Kaplan‐Meier analysis demonstrated that the incidence of rehospitalization due to HF, cardiac death, all‐cause death and cerebrovascular event in the In‐hos‐AF group was not significantly different from that in the Control group (P > 0.05 respectively). However, when AF recurred in the In‐hos‐AF group patients (n = 24, 41%) after discharge, the incidence of rehospitalization due to HF and cardiac deaths were higher than those without AF recurrence (P = 0.018 and P = 0.027 respectively). Cox proportional analysis revealed that AF developing after discharge was proven to be an independent risk factor for rehospitalization due to HF (HR 1.845, P = 0.043), cardiac death (HR 3.562, P = 0.013) and all‐cause deaths (HR 2.138, P = 0.020). Conclusion Clinical outcomes of new‐onset in‐hospital AF patients were as good as those without AF history until AF recurrence. However, AF recurrence led to worse prognosis. Therefore, treatment for new‐onset in‐hospital AF in ADHF patients might be postponed until AF recurrence. |
topic |
acute heart failure atrial fibrillation after discharge cardiac death cerebrovascular event new‐onset in‐hospital atrial fibrillation |
url |
https://doi.org/10.1002/joa3.12386 |
work_keys_str_mv |
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