Role of permanent atrial fibrillation (AF) on long-term mortality in community-dwelling elderly people with and without chronic heart failure (CHF)

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• 作者：Gianluca Testa^a ; ^b ; Francesco Cacciatore^c ; David Della-Morte^a ; ^d ; Gianluigi Galizia^a ; ^e ; Francesca Mazzella^a ; ^c ; Gaetano Gargiulo^a ; Assunta Langellotto^a ; Daniele D&rsquo ; Ambrosio^a ; Nicola Ferrara^c ; ^f ; Franco Rengo^a ; ^c ; Pasquale Abete^a ; ^{p.abete@unina.it}
• 关键词：Atrial fibrillation in elderly ; Morbidity in elderly ; Mortality in elderly ; Chronic heart failure
• 刊名：Archives of Gerontology and Geriatrics
• 出版年：2012
• 期刊代码：23_01674943
• 类别：med
• 出版时间：July-August, 2012
• 卷：55
• 期：1
• 页码：91-95
• 文件大小：210 K

摘要

Permanent AF is characterized by an increased mortality in elderly subjects with CHF. Moreover, AF increased the risk of mortality also in elderly subjects without CHF. Thus, we examined long-term mortality in community-dwelling elderly people with and without CHF. A total of 1332 subjects aged 65 and older were selected from the electoral rolls of Campania, a region of southern Italy. The relationship between AF and mortality during a 12-year follow-up in 125 subjects with CHF and in 1.143 subjects without CHF were studied. Elderly subjects showed a higher mortality in those with respect to those without AF (72.1%vs. 51.8%; p < 0.01). Similarly, elderly subjects without CHF showed a higher mortality in those with respect to those without AF (61.8%vs. 49.8%; p < 0.05). In contrast, elderly subjects with CHF showed a similar mortality in those with respect to those without AF (74.7%vs. 82.4%; p = 0.234). Multivariate analysis shows that AF was predictive of mortality in all elderly subjects (Hazard Risk = HR = 1.39, 95%confidence interval (CI) = 1.25-2.82; p < 0.001). When the analysis was conducted considering the presence and the absence of CHF, AF was strongly predictive of mortality in elderly subjects without CHF (HR = 1.95, 95%CI = 1.25-4.51; p < 0.001) but not in those with CHF (HR = 1.12, 95%CI = 0.97-3.69; p = 0.321). We concluded that AF is able to predict long-term mortality in elderly subjects. Moreover, AF is strongly predictive of long-term mortality in the absence but not in the presence of CHF.