Abstract 10386: Is New Onset Atrial Fibrillation a Surrogate Marker for Heart Failure Progression?
Framingham data indicate that the onsets of atrial fibrillation (AF) and chronic heart failure (HF) are often related, and in the presence of one the onset of the other increases mortality risk. These data contribute to the evidence that AF and HF have interrelated pathophysiologies, and conjoined natural histories. To test the hypothesis that new onset AF is a surrogate marker for HF progression, in the BEST trial (low LVEF advanced HF, beta-blocker bucindolol vs. placebo) we measured the all-cause mortality (ACM) and total HF hospitalization (HFH days/pt) before and after the development of new onset AF, in patients who did not have AF at randomization. [TABLE 1] In addition, we performed a within treatment group multivariate stepwise analysis (MVA) for 16 variables potentially affecting time to HFH: (Cox model p values in order of acceptance into the model, all univariate predictors are p<0.001) [TABLE 2]
Summary: 1) In BEST new onset AF was associated with a 2.1 fold increase in ACM, and a 1.8 fold increase in HFH days/pt; 2) in placebo treated patients new onset AF is the most statistically significant predictor of HFH on MVA; 3) in bucindolol treated new onset AF also predicts HFH, but LVEF change was the strongest predictor.
Conclusions: New onset AF is a surrogate marker for heart failure progression.
- © 2011 by American Heart Association, Inc.