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Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study

Greve, Anders M. (författare)
Gerdts, Eva (författare)
Boman, Kurt, (författare)
Umeå universitet, Medicin, Dept Med Skellefta, Skellefta, Sweden
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Gohlke-Baerwolf, Christa (författare)
Rossebo, Anne B. (författare)
Nienaber, Christoph A. (författare)
Ray, Simon (författare)
Egstrup, Kenneth (författare)
Pedersen, Terje R. (författare)
Kober, Lars (författare)
Willenheimer, Ronnie (författare)
Wachtell, Kristian (författare)
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Umeå universitet Medicinska fakulteten. Institutionen för folkhälsa och klinisk medicin. Medicin. (creator_code:org_t)
Lunds universitet Kardiologiska klinikens forskargrupp. (creator_code:org_t)
2013
Engelska.
Ingår i: International Journal of Cardiology. - Elsevier. - 0167-5273. ; 166:1, s. 72-76
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Background: The frequency and prognostic importance of atrial fibrillation (AF) in asymptomatic mild-to-moderate aortic stenosis (AS) has not been well described. Methods: Clinical examination, electrocardiography and echocardiography were obtained in asymptomatic patients with mild-to-moderate AS and preserved left ventricular (LV) systolic function, randomized to simvastatin/ezetimibe combination vs. placebo in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. At inclusion, AF was categorized as episodic or longstanding. Rhythm change was assessed on annual in-study electrocardiograms. Impact of AF on cardiovascular morbidity and mortality was determined by adjusting for biomarkers, clinical- and echocardiographic covariates. Results: Mean follow-up was 4.3 +/- 0.8 years (6,721 patient-years of follow-up). At baseline, episodic AF was present in 87 patients (5.6%), longstanding AF in 55 (3.5%) and no AF in 1,421 (90.9%). Incidence of new-onset AF was 1.2%/year; highest in those with impaired LV function. In multivariable analysis, longstanding AF was compared to no AF at baseline, associated with a 4.1-fold higher risk of heart failure (CI 1.2 to 13.8, p = 0.02) and a 4.8-fold higher risk of non-hemorrhagic stroke (CI 1.7 to 13.6, p = 0.003). Conclusion: Rate of AF is moderate in asymptomatic AS. Longstanding but not episodic AF was, independently predictive of increased risk of heart failure and non-hemorrhagic stroke. New-onset AF was associated with cardiac decompensation. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Asymptomatic aortic stenosis
Atrial fibrillation
Outcome

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