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  • Greve, Anders M. (author)

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

  • Article/chapterEnglish2013

Publisher, publication year, extent ...

  • Elsevier BV,2013

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  • LIBRIS-ID:oai:lup.lub.lu.se:c5396c41-797a-49c0-b29a-4c24ac3d8a15
  • https://lup.lub.lu.se/record/3932403URI
  • https://doi.org/10.1016/j.ijcard.2011.09.064DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-73556URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • 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.

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  • Gerdts, Eva (author)
  • Boman, KurtUmeå universitet,Medicin,Dept Med Skellefta, Skellefta, Sweden(Swepub:umu)kubo0001 (author)
  • Gohlke-Baerwolf, Christa (author)
  • Rossebo, Anne B. (author)
  • Nienaber, Christoph A. (author)
  • Ray, Simon (author)
  • Egstrup, Kenneth (author)
  • Pedersen, Terje R. (author)
  • Kober, Lars (author)
  • Willenheimer, RonnieLund University,Lunds universitet,Kardiologiska klinikens forskargrupp,Forskargrupper vid Lunds universitet,Cardiology Research Group,Lund University Research Groups(Swepub:lu)medf-rw0 (author)
  • Wachtell, Kristian (author)
  • Umeå universitetMedicin (creator_code:org_t)

Related titles

  • In:International Journal of Cardiology: Elsevier BV166:1, s. 72-760167-52731874-1754

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