Differential Prognostic Impact of Atrial Fibrillation in Hospitalized Heart Failure Patients With Preserved Ejection Fraction According to Coronary Artery Disease Status　― Report From the Japanese Nationwide Multicenter Registry ―

• Temma Taro

  Department of Telemedicine for Comprehensive Heart Failure Management, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Nagai Toshiyuki

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Watanabe Masaya

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Kamada Rui

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Takahashi Yumi

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Hagiwara Hikaru

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Koya Taro

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Nakao Motoki

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Omote Kazunori

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Kamiya Kiwamu

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Iwano Hiroyuki

  Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

• Yamamoto Kazuhiro

  Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University

• Yoshikawa Tsutomu

  Department of Cardiology, Sakakibara Heart Institute

• Saito Yoshihiko

  First Department of Internal Medicine, Nara Medical University

• Anzai Toshihisa

  Department of Telemedicine for Comprehensive Heart Failure Management, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

抄録

Background:Atrial fibrillation (AF) is an important prognostic determinant in heart failure (HF) with preserved ejection fraction (HFpEF). However, it is unclear which HFpEF phenotypes are affected by AF in terms of long-term clinical outcomes because HFpEF is a heterogeneous syndrome with comorbidities such as coronary artery disease (CAD). In this study we determined the differential prognostic significance of AF in HFpEF patients according to CAD status. Methods and Results:Data for 408 hospitalized HFpEF patients enrolled in the Japanese Heart Failure Syndrome with Preserved Ejection Fraction Nationwide Multicenter Registry were analyzed. Patients were divided into 4 groups according to the presence of AF and CAD. The primary outcome was the composite of all-cause death and HF rehospitalization. The incidence of adverse events was higher in the AF–non-CAD than non-AF–non-CAD group (P=0.004). On multivariable Cox regression analysis with prespecified confounders, AF–non-CAD was significantly associated with an increased risk of adverse events than non-AF–non-CAD (adjusted HR, 1.91; 95% CI: 1.02–3.92) regardless of the type of AF. In contrast, risk was comparable between the AF–CAD and non-AF–CAD groups (adjusted HR, 1.24; 95% CI: 0.64–2.47). Conclusions:In HFpEF patients without CAD, AF was independently related to adverse events, indicating that intensive management of AF would have more beneficial effects particularly in HFpEF patients without CAD.

収録刊行物

• Circulation Journal

  Circulation Journal 84 (3), 397-403, 2020-02-25

  一般社団法人 日本循環器学会

キーワード

• All-cause death
• Atrial fibrillation
• Coronary artery disease
• Heart failure with preserved ejection fraction

詳細情報

• CRID: 1390565134830636160
• NII論文ID: 130007801781
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-19-0963
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 030281803
• PubMed: 32009066
• Web Site: http://id.ndl.go.jp/bib/030281803
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I030281803
• Web Site: https://www.jstage.jst.go.jp/article/circj/84/3/84_CJ-19-0963/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020287955
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
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