Reference : A meta-analysis of the prognostic significance of atrial fibrillation in chronic hear...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/10993/18354
A meta-analysis of the prognostic significance of atrial fibrillation in chronic heart failure.
English
Mamas, Mamas A. [> >]
Caldwell, Jane C. [> >]
Chacko, Sanoj [> >]
Garratt, Clifford J. [> >]
Fath-Ordoubadi, Farzin [> >]
Neyses, Ludwig mailto [University of Luxembourg > Research Office]
2009
European journal of heart failure
11
7
676-83
Yes (verified by ORBilu)
International
1388-9842
Netherlands
[en] Aged ; Atrial Fibrillation/mortality/physiopathology ; Confidence Intervals ; Female ; Great Britain ; Heart Failure/mortality ; Heart Failure, Systolic/mortality ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Prognosis ; Randomized Controlled Trials as Topic ; Risk Assessment ; Ventricular Function, Left
[en] AIMS: 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. METHODS AND RESULTS: 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, P < 0.0001] in randomized trials and an OR of 1.14 (95% CI 1.03-1.26, P < 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. CONCLUSION: 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.
http://hdl.handle.net/10993/18354
10.1093/eurjhf/hfp085
http://onlinelibrary.wiley.com/doi/10.1093/eurjhf/hfp085/abstract

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