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Prognostic importan...
Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study
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Greve, Anders M. (author)
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Gerdts, Eva (author)
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- Boman, Kurt (author)
- Umeå universitet,Medicin,Dept Med Skellefta, Skellefta, Sweden
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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, Ronnie (author)
- Lund University,Lunds universitet,Kardiologiska klinikens forskargrupp,Forskargrupper vid Lunds universitet,Cardiology Research Group,Lund University Research Groups
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Wachtell, Kristian (author)
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(creator_code:org_t)
- Elsevier BV, 2013
- 2013
- English.
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In: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 166:1, s. 72-76
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http://dx.doi.org/10...
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Abstract
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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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Asymptomatic aortic stenosis
- Atrial fibrillation
- Outcome
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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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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show more...
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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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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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International Jo ...
- By the university
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Lund University
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Umeå University