JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2007; 49:376, doi:10.1016/j.jacc.2006.10.035 (Published online 3 January 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.10.035v1
49/3/376    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Parkash, R.
Right arrow Articles by Stevenson, W. G.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Parkash, R.
Right arrow Articles by Stevenson, W. G.
Related Collections
Right arrowRelated Articles

CORRESPONDENCE: LETTER TO THE EDITOR

Atrial Fibrillation and Clinical Events in Chronic Heart Failure

Ratika Parkash, MD, MSc* and William G. Stevenson, MD

* QEII Health Science Centre, 1796 Summer Street, Room 2501D, Halifax, Nova Scotia B3H 3A7, Canada (Email: parkashr{at}cdha.nshealth.ca).

The study by Olsson et al. (1) found that atrial fibrillation (AF) is associated with a worse outcome in patients with heart failure (HF) regardless of whether HF is associated with depressed or relatively preserved ventricular function, although those with preserved left ventricular (LV) function had better survival than did those with depressed LV function. In a series of 478 patients hospitalized with AF and HF we observed that those with preserved LV function had a similarly poor prognosis as did those with depressed LV function when adjusted for age, gender, coronary artery disease, and comorbid illness (2).

Differences in these findings might be illuminating. Whereas the CHARM (Candesartan in Heart failure-Assessment of Reduction in mortality and morbidity) program enrolled stable HF patients, our study population were patients who had a deterioration necessitating hospitalization. We observed a steep increase in mortality shortly after the index hospitalization, suggesting that such an event is a potent marker for mortality warranting aggressive management. We also found an association between decreased mortality and statin therapy, intriguing in view of recent speculation that inflammation and fibrosis may be involed in promoting AF. It would be of interest to know whether intercurrent development of AF had a different prognosis as compared to preexisting AF in CHARM and whether statin therapy disproportionately affects outcomes.


   References
Top
 References
 

  1. Olsson LG, Swedberg K, Ducharme A, et al. Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: results from the Candesartan in Heart failure-Assessment of Reduction in mortality and morbidity (CHARM) program J Am Coll Cardiol 2006;47:1997-2004.[Abstract/Free Full Text]
  2. Parkash R, Maisel WH, Toca FM, Stevenson WG. Atrial fibrillation in heart failure: high mortality risk even if ventricular function is preserved Am Heart J 2005;150:701-706.[CrossRef][ISI][Medline]

Related Articles

Atrial Fibrillation and Clinical Events in Chronic Heart Failure
Ratika Parkash and William G. Stevenson
J. Am. Coll. Cardiol. 2007 49: 376. [Full Text] [PDF]

Reply
Lars Olsson, Marc A. Pfeffer, and Karl Swedberg
J. Am. Coll. Cardiol. 2007 49: 376-377. [Full Text] [PDF]




This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.10.035v1
49/3/376    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Parkash, R.
Right arrow Articles by Stevenson, W. G.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Parkash, R.
Right arrow Articles by Stevenson, W. G.
Related Collections
Right arrowRelated Articles

HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK