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Risk factors for heart failure hospitalizations among patients with atrial fibrillation

Lucien Eggimann, Steffen Blum, Stefanie Aeschbacher, Andreas Reusser, Peter Ammann, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jürg Schläpfer, Nadine Mondet, Michael Kühne, Christian Sticherling, Stefan Osswald & David Conen

abstract

BACKGROUND
Patients with atrial fibrillation (AF) have an increased risk for the development of heart failure (HF). In this study, we aimed to detect predictors of HF hospitalizations in an unselected AF population.

METHODS
The Basel Atrial Fibrillation Cohort Study is an ongoing observational multicenter cohort study in Switzerland. For this analysis, 1193 patients with documented AF underwent clinical examination, venous blood sampling and resting 12-lead ECG at baseline. Questionnaires about lifestyle and medical history were obtained in person at baseline and during yearly follow-up phone calls. HF hospitalizations were validated by two independent physicians. Cox regression analyses were performed using a forward selection strategy.

RESULTS
Overall, 29.8% of all patients were female and mean age was 69 ±12 years. Mean follow-up time was 3.7 ±1.5 years. Hospitalization for HF occurred in 110 patients, corresponding to an incidence of 2.5 events per 100 person years of follow-up. Independent predictors for HF were body mass index (HR 1.40 [95%CI 1.17; 1.66], p = 0.0002), chronic kidney disease (2.27 [1.49; 3.45], p = 0.0001), diabetes mellitus (2.13 [1.41; 3.24], p = 0.0004), QTc interval (1.25 [1.04; 1.49], p = 0.02), brain natriuretic peptide (2.19 [1.73; 2.77], p<0.0001), diastolic blood pressure (0.79 [0.65; 0.96], p = 0.02), history of pulmonary vein isolation or electrical cardioversion (0.54 [0.36; 0.80], p = 0.003) and serum chloride (0.82 [0.70; 0.96], p = 0.02).

CONCLUSIONS
In this unselected AF population, several traditional cardiovascular risk factors and arrhythmia interventions predicted HF hospitalizations, providing potential opportunities for the implementation of strategies to reduce HF among AF patients.
   
citation Eggimann L, Blum S, Aeschbacher S, Reusser A, Ammann P, Erne P, Moschovitis G, Di Valentino M, Shah D, Schläpfer J, Mondet N, Kühne M, Sticherling C, Osswald S, Conen D. Risk factors for heart failure hospitalizations among patients with atrial fibrillation. PLoS ONE 2018; 13:e0191736.
   
type journal paper/review (English)
date of publishing 02-02-2018
journal title PLoS ONE (13/2)
ISSN electronic 1932-6203
pages e0191736
PubMed 29394253
DOI 10.1371/journal.pone.0191736