Atrial fibrillation is a marker of increased mortality risk in nonischemic heart failure—Results from the DANISH trial
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Atrial fibrillation is a marker of increased mortality risk in nonischemic heart failure—Results from the DANISH trial. / Boas, Rune; Thune, Jens Jakob; Pehrson, Steen; Køber, Lars; Nielsen, Jens C.; Videbæk, Lars; Haarbo, Jens; Korup, Eva; Bruun, Niels Eske; Brandes, Axel; Eiskjær, Hans; Thøgersen, Anna M.; Philbert, Berit T.; Svendsen, Jesper Hastrup; Dixen, Ulrik.
I: American Heart Journal, Bind 232, 2021, s. 61-70.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Atrial fibrillation is a marker of increased mortality risk in nonischemic heart failure—Results from the DANISH trial
AU - Boas, Rune
AU - Thune, Jens Jakob
AU - Pehrson, Steen
AU - Køber, Lars
AU - Nielsen, Jens C.
AU - Videbæk, Lars
AU - Haarbo, Jens
AU - Korup, Eva
AU - Bruun, Niels Eske
AU - Brandes, Axel
AU - Eiskjær, Hans
AU - Thøgersen, Anna M.
AU - Philbert, Berit T.
AU - Svendsen, Jesper Hastrup
AU - Dixen, Ulrik
PY - 2021
Y1 - 2021
N2 - Background: Atrial fibrillation (AF) in heart failure (HF) patients has been associated with a worse outcome. Similarly, excessive supraventricular ectopic activity (ESVEA) has been linked to development of AF, stroke, and death. This study aimed to investigate AF and ESVEA's association with outcomes and effect of prophylactic implantable cardioverter defibrillator (ICD) implantation in nonischemic HF patients. Methods: A total of 850 patients with nonischemic HF, left ventricle ejection fraction ≤35%, and elevated N-terminal pro-brain natriuretic peptides underwent 24 hours Holter recording. The presence of AF (≥30 seconds) and ESVEA (≥30 supraventricular ectopic complexes (SVEC) per hour or run of SVEC ≥20 beats) were registered. Outcomes were all-cause mortality, cardiovascular death (CVD), and sudden cardiac death (SCD). Results: AF was identified in 188 patients (22%) and ESVEA in 84 patients (10%). After 4 years and 11 months of follow-up, a total of 193 patients (23%) had died. AF was associated with all-cause mortality (hazard ratio [HR] 1.44; confidence interval [CI] 1.04-1.99; P = .03) and CVD (HR 1.59; CI 1.07-2.36; P = .02). ESVEA was associated with all-cause mortality (HR 1.73; CI 1.16-2.57; P = .0073) and CVD (HR 1.76; CI 1.06-2.92; P = .03). Neither AF nor ESVEA was associated with SCD. ICD implantation was not associated with an improved prognosis for neither AF (P value for interaction = .17), nor ESVEA (P value for interaction = .68). Conclusions: Both AF and ESVEA were associated with worsened prognosis in nonischemic HF. However, ICD implantation was not associated with an improved prognosis for either group.
AB - Background: Atrial fibrillation (AF) in heart failure (HF) patients has been associated with a worse outcome. Similarly, excessive supraventricular ectopic activity (ESVEA) has been linked to development of AF, stroke, and death. This study aimed to investigate AF and ESVEA's association with outcomes and effect of prophylactic implantable cardioverter defibrillator (ICD) implantation in nonischemic HF patients. Methods: A total of 850 patients with nonischemic HF, left ventricle ejection fraction ≤35%, and elevated N-terminal pro-brain natriuretic peptides underwent 24 hours Holter recording. The presence of AF (≥30 seconds) and ESVEA (≥30 supraventricular ectopic complexes (SVEC) per hour or run of SVEC ≥20 beats) were registered. Outcomes were all-cause mortality, cardiovascular death (CVD), and sudden cardiac death (SCD). Results: AF was identified in 188 patients (22%) and ESVEA in 84 patients (10%). After 4 years and 11 months of follow-up, a total of 193 patients (23%) had died. AF was associated with all-cause mortality (hazard ratio [HR] 1.44; confidence interval [CI] 1.04-1.99; P = .03) and CVD (HR 1.59; CI 1.07-2.36; P = .02). ESVEA was associated with all-cause mortality (HR 1.73; CI 1.16-2.57; P = .0073) and CVD (HR 1.76; CI 1.06-2.92; P = .03). Neither AF nor ESVEA was associated with SCD. ICD implantation was not associated with an improved prognosis for neither AF (P value for interaction = .17), nor ESVEA (P value for interaction = .68). Conclusions: Both AF and ESVEA were associated with worsened prognosis in nonischemic HF. However, ICD implantation was not associated with an improved prognosis for either group.
U2 - 10.1016/j.ahj.2020.10.073
DO - 10.1016/j.ahj.2020.10.073
M3 - Journal article
C2 - 33144085
AN - SCOPUS:85097392998
VL - 232
SP - 61
EP - 70
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
ER -
ID: 254522281