A meta‐analysis of the prognostic significance of atrial fibrillation in chronic heart failure
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- Mamas A. Mamas
- Department of Cardiology Manchester University Manchester UK
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- Jane C. Caldwell
- Department of Cardiology Manchester University Manchester UK
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- Sanoj Chacko
- Manchester Heart Centre Manchester Royal Infirmary Oxford Road Manchester M13 9WL UK
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- Clifford J. Garratt
- Department of Cardiology Manchester University Manchester UK
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- Farzin Fath‐Ordoubadi
- Manchester Heart Centre Manchester Royal Infirmary Oxford Road Manchester M13 9WL UK
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- Ludwig Neyses
- Department of Cardiology Manchester University Manchester UK
説明
<jats:sec><jats:title>Aims</jats:title><jats:p>Atrial fibrillation (AF) is one of the commonest sustained arrhythmias in chronic heart failure (CHF), although the prognostic implications of the presence of AF in CHF remain controversial. We have therefore performed this meta‐analysis to study the effects of the presence of AF on mortality in CHF patients.</jats:p></jats:sec><jats:sec><jats:title>Methods and results</jats:title><jats:p>A systematic MEDLINE search for all randomized trials and observational studies in which the influence of AF on CHF mortality was investigated and meta‐analysis of the mortality data was performed. A total of 16 studies were identified of which 7 were randomized trials and 9 were observational studies including 30 248 and 23 721 patients, respectively. An adjusted meta‐analysis of the data revealed that the presence of AF is associated with an adverse effect on total mortality with an odds ratio (OR) of 1.40 [95% confidence interval (CI) 1.32–1.48, <jats:italic>P</jats:italic> < 0.0001] in randomized trials and an OR of 1.14 (95% CI 1.03–1.26, <jats:italic>P</jats:italic> < 0.05) in observational studies. This increase in mortality associated with the presence of AF was observed in subgroups of CHF patients with both preserved and impaired left ventricular (LV) systolic function.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In conclusion, meta‐analysis of 16 studies involving 53 969 patients suggests that the presence of AF is associated with an adverse prognosis in CHF irrespective of LV systolic function.</jats:p></jats:sec>
収録刊行物
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- European Journal of Heart Failure
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European Journal of Heart Failure 11 (7), 676-683, 2009-06-24
Wiley