Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:155-61 - Vol. 71 Num.03 DOI: 10.1016/j.rec.2017.03.026

Mortality and Atrial Fibrillation in the FIACA Study: Evidence of a Differential Effect According to Admission Diagnosis

Francisco Guillermo Clavel-Ruipérez a, Luciano Consuegra-Sánchez a, Francisco Javier Félix Redondo b, Luis Lozano Mera b,c, Pedro Mellado-Delgado b, Juan José Martínez-Díaz a, José Ramón López Mínguez d, Daniel Fernández-Bergés b,

a Servicio de Cardiología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain
b Unidad de Investigación, Programa de Investigación en Enfermedades Cardiovasculares PERICLES, Servicio Extremeño de Salud, Área de Salud Don Benito-Villanueva, Villanueva de la Serena, Badajoz, Spain
c Centro de Salud Urbano I, Servicio Extremeño de Salud, Mérida, Badajoz, Spain
d Unidad de Hemodinámica, Servicio de Cardiología, Hospital Universitario Infanta Cristina, Badajoz, Spain

Refers to

Atrial Fibrillation: A Riddle Wrapped in a Mystery Inside an Enigma
Claire Alexandra Lawson, Mamas Andreas Mamas
Rev Esp Cardiol. 2018;71:139-40
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Keywords

Atrial fibrillation. Prognosis. Heart failure. Acute myocardial infarction. Ischemic stroke.

Abstract

Introduction and objectives

Atrial fibrillation (AF) is an independent risk factor for mortality in several diseases. However, data published in acute decompensated heart failure (DHF) are contradictory. Our objective was to investigate the impact of AF on mortality in patients admitted to hospital for DHF compared with those admitted for other reasons.

Methods

This retrospective cohort study included all patients admitted to hospital within a 10-year period due to DHF, acute myocardial infarction (AMI), or ischemic stroke (IS), with a median follow-up of 6.2 years.

Results

We included 6613 patients (74 ± 11 years; 54.6% male); 2177 with AMI, 2208 with DHF, and 2228 with IS. Crude postdischarge mortality was higher in patients with AF hospitalized for AMI (incident rate ratio, 2.48; P < .001) and IS (incident rate ratio, 1.84; P < .001) than in those without AF. No differences were found in patients with DHF (incident rate ratio, 0.90; P = .12). In adjusted models, AF was not an independent predictor of in-hospital mortality by clinical diagnosis. However, AF emerged as an independent predictor of postdischarge mortality in patients with AMI (HR, 1.494; P = .001) and IS (HR, 1.426; P < .001), but not in patients admitted for DHF (HR, 0.964; P = .603).

Conclusions

AF was as an independent risk factor for postdischarge mortality in patients admitted to hospital for AMI and IS but not in those admitted for DHF.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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