Prognostic significance of present atrial fibrillation on a single office electrocardiogram in patients with atrial fibrillation.
J Intern Med
; 289(3): 395-403, 2021 03.
Article
en En
| MEDLINE
| ID: mdl-32914467
ABSTRACT
BACKGROUND:
Evidence for the association of atrial fibrillation (AF) present on the ECG and cardiovascular outcomes in AF patients is limited.OBJECTIVE:
To investigate the prognostic significance of AF on a single surface ECG for cardiovascular outcomes in AF patients.METHODS:
A total of 3642 AF patients were prospectively enrolled. Main exclusion criteria were rhythms other than sinus rhythm (SR) or AF. The primary end-point was a composite of all-cause death and hospitalizations for congestive heart failure (CHF). Secondary end-points were all-cause death, CHF hospitalizations, cardiovascular death, myocardial infarction, any stroke and stroke subtypes. Associations were assessed with multivariable Cox proportional hazards models.RESULTS:
Mean age was 71 years, 28% were female, and mean follow-up was 3.4 years. Patients with SR on the ECG at study enrolment (56%) were younger (69 vs. 74 years, P < 0.0001), had more often paroxysmal AF (73 vs. 18%, P < 0.0001) and fewer comorbidities. The incidence of the primary end-point was 1.8 and 3.1 per 100 person-years in patients with SR and AF, respectively. The multivariable-adjusted hazard ratio was 1.4 (95% confidence intervals 1.1; 1.7; P = 0.001) for patients with AF on the ECG compared to patients with SR. The hazard ratios (95% confidence intervals) were 1.4 (1.1; 1.8; P = 0.006) for all-cause death, 1.5 (1.2; 1.9; P = 0.001) for CHF and 1.6 (1.1; 2.2; P = 0.006) for cardiovascular death. None of the other associations were statistically significant.CONCLUSIONS:
The presence of AF in a single office ECG had significant prognostic implications with regard to mortality and CHF hospitalizations in patients with AF. These patients present a high-risk group and might benefit from intensified treatment.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Electrocardiografía
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
J Intern Med
Asunto de la revista:
MEDICINA INTERNA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Suiza