Clinical and echocardiographic factors associated with new-onset atrial fibrillation in heart failure - Subanalysis of the WARCEF trial

WARCEF

Research output: Contribution to journalArticle

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Abstract

Background: Heart failure (HF) patients have a high incidence of new-onset AF. Given the adverse prognostic influence of AF in HF, identifying patients at high risk of developing AF is important. Methods and Results: The incidence and factors associated with new-onset AF were investigated in patients in sinus rhythm with reduced LVEF enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial. Analyses involved clinical factors alone (n=2,219), and clinical plus echocardiographic findings (n=1,125). During 3.5±1.8 years of follow-up, 212 patients (9.6% of total cohort) developed AF. In both samples, new-onset AF was associated with age, male sex, White race, and IHD. Among echocardiographic variables, only LAD predicted AF. On multivariate Cox modeling, age (HR, 1.02; 95% CI: 1.00–1.03, P=0.008), IHD (HR, 1.37; 95% CI: 1.02–1.84, P=0.036) and LAD (HR, 1.48; 95% CI: 1.15–1.91, P=0.003) remained associated with AF onset. Patients with IHD, LAD>4.5 cm and age>50 years had a 2.5-fold higher risk of AF than patients without any of these characteristics (HR, 2.52; 95% CI: 1.72–3.69, P

Original languageEnglish (US)
Pages (from-to)619-626
Number of pages8
JournalCirculation Journal
Volume80
Issue number3
DOIs
StatePublished - Feb 25 2016

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Warfarin
Atrial Fibrillation
Aspirin
Heart Failure
Incidence

Keywords

  • Atrial fibrillation
  • Echocardiography
  • Heart failure
  • Prognosis
  • Risk assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical and echocardiographic factors associated with new-onset atrial fibrillation in heart failure - Subanalysis of the WARCEF trial. / WARCEF.

In: Circulation Journal, Vol. 80, No. 3, 25.02.2016, p. 619-626.

Research output: Contribution to journalArticle

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title = "Clinical and echocardiographic factors associated with new-onset atrial fibrillation in heart failure - Subanalysis of the WARCEF trial",
abstract = "Background: Heart failure (HF) patients have a high incidence of new-onset AF. Given the adverse prognostic influence of AF in HF, identifying patients at high risk of developing AF is important. Methods and Results: The incidence and factors associated with new-onset AF were investigated in patients in sinus rhythm with reduced LVEF enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial. Analyses involved clinical factors alone (n=2,219), and clinical plus echocardiographic findings (n=1,125). During 3.5±1.8 years of follow-up, 212 patients (9.6{\%} of total cohort) developed AF. In both samples, new-onset AF was associated with age, male sex, White race, and IHD. Among echocardiographic variables, only LAD predicted AF. On multivariate Cox modeling, age (HR, 1.02; 95{\%} CI: 1.00–1.03, P=0.008), IHD (HR, 1.37; 95{\%} CI: 1.02–1.84, P=0.036) and LAD (HR, 1.48; 95{\%} CI: 1.15–1.91, P=0.003) remained associated with AF onset. Patients with IHD, LAD>4.5 cm and age>50 years had a 2.5-fold higher risk of AF than patients without any of these characteristics (HR, 2.52; 95{\%} CI: 1.72–3.69, P",
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T1 - Clinical and echocardiographic factors associated with new-onset atrial fibrillation in heart failure - Subanalysis of the WARCEF trial

AU - WARCEF

AU - Kato, Tomoko S.

AU - Di Tullio, Marco R.

AU - Qian, Min

AU - Wu, Mengfei

AU - Thompson, John L P

AU - Mann, Douglas L.

AU - Sacco, Ralph L

AU - Pullicino, Patrick M.

AU - Freudenberger, Ronald S.

AU - Teerlink, John R.

AU - Graham, Susan

AU - Lip, Gregory Y H

AU - Levin, Bruce

AU - Mohr, Jay P.

AU - Labovitz, Arthur J.

AU - Estol, Conrado J.

AU - Lok, Dirk J.

AU - Ponikowski, Piotr

AU - Anker, Stefan D.

AU - Homma, Shunichi

PY - 2016/2/25

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N2 - Background: Heart failure (HF) patients have a high incidence of new-onset AF. Given the adverse prognostic influence of AF in HF, identifying patients at high risk of developing AF is important. Methods and Results: The incidence and factors associated with new-onset AF were investigated in patients in sinus rhythm with reduced LVEF enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial. Analyses involved clinical factors alone (n=2,219), and clinical plus echocardiographic findings (n=1,125). During 3.5±1.8 years of follow-up, 212 patients (9.6% of total cohort) developed AF. In both samples, new-onset AF was associated with age, male sex, White race, and IHD. Among echocardiographic variables, only LAD predicted AF. On multivariate Cox modeling, age (HR, 1.02; 95% CI: 1.00–1.03, P=0.008), IHD (HR, 1.37; 95% CI: 1.02–1.84, P=0.036) and LAD (HR, 1.48; 95% CI: 1.15–1.91, P=0.003) remained associated with AF onset. Patients with IHD, LAD>4.5 cm and age>50 years had a 2.5-fold higher risk of AF than patients without any of these characteristics (HR, 2.52; 95% CI: 1.72–3.69, P

AB - Background: Heart failure (HF) patients have a high incidence of new-onset AF. Given the adverse prognostic influence of AF in HF, identifying patients at high risk of developing AF is important. Methods and Results: The incidence and factors associated with new-onset AF were investigated in patients in sinus rhythm with reduced LVEF enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) trial. Analyses involved clinical factors alone (n=2,219), and clinical plus echocardiographic findings (n=1,125). During 3.5±1.8 years of follow-up, 212 patients (9.6% of total cohort) developed AF. In both samples, new-onset AF was associated with age, male sex, White race, and IHD. Among echocardiographic variables, only LAD predicted AF. On multivariate Cox modeling, age (HR, 1.02; 95% CI: 1.00–1.03, P=0.008), IHD (HR, 1.37; 95% CI: 1.02–1.84, P=0.036) and LAD (HR, 1.48; 95% CI: 1.15–1.91, P=0.003) remained associated with AF onset. Patients with IHD, LAD>4.5 cm and age>50 years had a 2.5-fold higher risk of AF than patients without any of these characteristics (HR, 2.52; 95% CI: 1.72–3.69, P

KW - Atrial fibrillation

KW - Echocardiography

KW - Heart failure

KW - Prognosis

KW - Risk assessment

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