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Prognostic importan...
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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
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LIBRIS-ID:oai:lup.lub.lu.se:c5396c41-797a-49c0-b29a-4c24ac3d8a15
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https://lup.lub.lu.se/record/3932403URI
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https://doi.org/10.1016/j.ijcard.2011.09.064DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-73556URI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
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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.
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Gerdts, Eva
(author)
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Boman, KurtUmeå universitet,Medicin,Dept Med Skellefta, Skellefta, Sweden(Swepub:umu)kubo0001
(author)
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Gohlke-Baerwolf, Christa
(author)
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Rossebo, Anne B.
(author)
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Nienaber, Christoph A.
(author)
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Ray, Simon
(author)
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Egstrup, Kenneth
(author)
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Pedersen, Terje R.
(author)
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Kober, Lars
(author)
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Willenheimer, RonnieLund University,Lunds universitet,Kardiologiska klinikens forskargrupp,Forskargrupper vid Lunds universitet,Cardiology Research Group,Lund University Research Groups(Swepub:lu)medf-rw0
(author)
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Wachtell, Kristian
(author)
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Umeå universitetMedicin
(creator_code:org_t)
Related titles
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In:International Journal of Cardiology: Elsevier BV166:1, s. 72-760167-52731874-1754
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Greve, Anders M.
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Gerdts, Eva
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Boman, Kurt
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Gohlke-Baerwolf, ...
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Rossebo, Anne B.
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Nienaber, Christ ...
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Ray, Simon
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Egstrup, Kenneth
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Pedersen, Terje ...
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Kober, Lars
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Willenheimer, Ro ...
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Wachtell, Kristi ...
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- MEDICAL AND HEALTH SCIENCES
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and Cardiac and Card ...
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Lund University
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Umeå University