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European Heart Journal Advance Access published online on January 6, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi694
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received June 26, 2005
Revised November 24, 2005
Accepted December 1, 2005

Clinical research

Incidence and mortality risk of congestive heart failure in atrial fibrillation patients: a community-based study over two decades

Yoko Miyasaka 1, Marion E. Barnes 1, Bernard J. Gersh 1, Stephen S. Cha 2, Kent R. Bailey 2, Walter Abhayaratna 1, James B. Seward 1, Toshiji Iwasaka 3, and Teresa S.M. Tsang 1 *

1 Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2 Section of Biostatistics, Mayo Clinic, Rochester, MN, USA
3 Cardiovascular Division, Department of Medicine II, Kansai Medical University, Osaka, Japan

* To whom correspondence should be addressed.
Teresa S.M. Tsang, E-mail: tsang.teresa{at}mayo.edu


  Abstract

Aims We sought to determine whether the incidence of and survival following congestive heart failure (CHF) in patients with atrial fibrillation (AF) have changed over time.

Methods and results Olmsted County, Minnesota residents diagnosed with first AF during 1980-2000 were identified and followed in medical records to 2004. The trends of incidence and survival of CHF over time were assessed. Of the 3288 subjects (mean age 71 ± 15 years) diagnosed with first AF and without CHF prior to or at AF diagnosis, 790 (24%) developed a first CHF during a mean follow-up of 6.1 ± 5.2 years (unadjusted incidence, 44 per 1000 person years). Age- and sex-adjusted CHF incidence was unrelated to calendar year of AF diagnosis (P = 0.86). The age- and sex-adjusted mortality risk following CHF was higher than that in patients without CHF (hazard ratio 3.4, 95% confidence interval 3.1-3.8, P < 0.0001). There were no detectable changes over time with respect to the absolute (P = 0.94) or the relative (P = 0.68) mortality risk after CHF diagnosis.

Conclusion In this study spanning two decades, there appeared to have been no significant reduction in terms of the incidence and mortality risk of CHF following first AF diagnosis.

Keywords: Atrial fibrillation; Heart failure; Incidence; Prognosis; Epidemiology.
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