Bidirectional association between atrial fibrillation and congestive heart failure in the elderly. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: O'Neal, Wesley T.; Qureshi, Waqas; Zhang, Zhu-Ming; Soliman, Elsayed Z.
• Is Part Of: Journal of cardiovascular medicine. Volume 17:Issue 3(2016:Mar.)
• Publication Date: 2016-03
• Subjects: atrial fibrillation -- epidemiology -- heart failure; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000289
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : Aims: The aim of this study was to examine the bidirectional association between atrial fibrillation and congestive heart failure (CHF) in older adults. Methods: We studied the association of atrial fibrillation at entry with incident CHF ( N = 5281; 85% white, 42% male) and the association of CHF at entry with incident atrial fibrillation ( N = 5233; 85% white, 42% male) in the Cardiovascular Health Study (CHS). Baseline atrial fibrillation was identified during the study electrocardiogram and by self-reported history, and incident cases were identified during subsequent study electrocardiograms and hospitalization data. Baseline CHF was identified by self-reported history and adjudication of medical records, and incident cases were identified using hospitalization data. Cox regression was used to compute hazard ratios and 95% confidence intervals (CIs) for the association between atrial fibrillation and incident CHF, and CHF and incident atrial fibrillation, separately. Results: Over a median follow-up of 12.6 years, 534 (10%) participants developed atrial fibrillation. CHF was associated with an increased risk of atrial fibrillation (hazard ratio 2.0, 95% CI 1.4, 3.0). A total of 1692 (32%) participants developed CHF over a median follow-up of 11.7 years and atrial fibrillation was associated with an increased risk of CHF (hazard ratio 1.9, 95% CI 1.5, 2.2). Conclusion: Our results suggest that a bidirectional relationship exists between atrial fibrillation and CHF, with each condition influencing the development of the other.