Abstract 16207: Progression From Paroxysmal to Sustained Atrial Fibrillation as an Increased Risk of Hospitalization for Heart Failure: The Fushimi Af Registry
Background: Atrial fibrillation (AF) increases the risks of hospitalization for heart failure as well as thromboembolism. Progression from paroxysmal to sustained types (persistent or permanent) of AF is sometimes seen, but outcomes of such patients were unknown. We investigated the association between progression of AF and clinical events in AF patients.
Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto, which is a typical urban district of Japan with a population of 283,000. Follow-up data including prescription status were available for 3,731 patients. We studied 1,827 paroxysmal AF patients at baseline.
Results: During the median follow-up of 1,103 days, progression from paroxysmal to sustained AF occurred in 205 patients (11.2%). Patients with AF progression did not show significant differences in the number of male (60.5% vs. 57.7%; p=0.44), mean age (73.1 vs. 72.1 years of age; p=0.27), mean BMI (23.4 vs. 22.8 kg/m2; p=0.051), systolic blood pressure (124.8 vs. 125.6 mmHg; p=0.60), heart rate (75.9 vs. 76.3 bpm; p=0.76) and CHA2DS2-VASc score (3.19 vs. 3.12; p=0.62). Patients with AF progression were likely to have pre-existing heart failure (22.4% vs. 16.8%; p=0.046). Patients with AF progression were more frequently prescribed oral anticoagulants (OAC) (55.6% vs. 38.9%; p<0.01) and beta-blockers (33.7% vs. 25.8%; p=0.02). On landmark analysis, hospitalization for heart failure occurred in 20 patients (9.8%) with AF progression, and in 91 (5.6%) without AF progression, with a multivariate hazard ratio adjusted by sex, age, heart failure, valvular heart disease, cardiomyopathy, hypertension, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease and beta-blockers prescription, of 2.04 (95% confidence interval, 1.22 to 3.26; p<0.01).
Conclusion: We identified that progression of AF was associated with an increased risk of hospitalization for heart failure in Japanese AF patients.
Author Disclosures: H. Ogawa: None. Y. An: None. M. Ishii: None. M. Iguchi: None. M. Esato: None. Y. Chun: None. H. Wada: None. K. Hasegawa: None. M. Abe: None. M. Akao: Research Grant; Modest; Boehringer Ingelheim, Bayer, Daiichi-Sankyo, Takeda Pharmaceutical. Speakers Bureau; Modest; Pfizer, Daiichi-Sankyo, Tanabe-Mitsubishi. Speakers Bureau; Significant; Bristol-Myers Squibb, Boehringer Ingelheim, Bayer.
- © 2016 by American Heart Association, Inc.