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首页> 外文期刊>Circulation journal >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 ―
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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 ―

机译：根据冠状动脉疾病状态的冠状动脉疾病状态治疗射血分数的住院心力衰竭患者心房颤动的差异预后影响 - 来自日本全国多中心注册表的报告 -

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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.
机译：背景：心房颤动（AF）是心力衰竭（HF）中的重要预后决定因子，具有保存的喷射级分（HFPEF）。然而，不清楚哪种HFPEF表型受到AG的长期临床结果的影响，因为HFPEF是一种异质综合征，其具有冠状动脉疾病（CAD）如冠状动脉疾病。在这项研究中，我们根据CAD状态确定了在HFPEF患者中的差异预后意义。方法？结果：分析了纳入日本心力衰竭综合征的408例住院HFPEF患者，全国范围内注册了全国射血分数。根据AF和CAD的存在，患者分为4组。主要结果是全导致死亡和HF再次研究的综合。 AF-NOR-CAD的不良事件的发生率高于非AF-NOR-CAD组（P = 0.004）。在具有预先收集的混凝剂的多变量COX回归分析中，由于无论类型如何，AF-非CAD都与不良事件的风险增加显着与不良事件的风险增加显着相关（调整的HR，1.91; 95％CI：1.02-3.92） AF。相比之下，AF-CAD和非AF-CAD组之间的风险相当（调整后的HR，1.24; 95％CI：0.64-2.47）。结论：在没有CAD的HFPEF患者中，AF与不良事件无关，表明AF的密集管理尤其是在没有CAD的HFPEF患者中具有更有益的效果。

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