ASSOCIATION OF ATRIAL FIBRILLATION ON LONG TERM SURVIVAL IN PATIENTS WITH DIASTOLIC HEART FAILURE

AimsACE inhibition reduces mortality and morbidity in patients with heart failure after acute myocardial infarction (AMI). However, there are limited randomised data about the long-term survival benefits of ACE inhibition in this population.MethodsIn 1993, the Acute Infarction Ramipril Efficacy (AIRE) study randomly allocated patients with AMI and clinical heart failure to ramipril or placebo. The duration of masked trial therapy in the UK cohort (603 patients, mean age=64.7 years, 455 male patients) was 12.4 and 13.4 months for ramipril (n=302) and placebo (n=301), respectively. We estimated life expectancy and extensions of life (difference in median survival times) according to duration of follow-up (range 0–29.6 years).ResultsBy 9 April 2019, death from all causes occurred in 266 (88.4%) patients in placebo arm and 275 (91.1%) patients in ramipril arm. The extension of life between ramipril and placebo groups was 14.5 months (95% CI 13.2 to 15.8). Ramipril increased life expectancy more for patients with than without diabetes (life expectancy difference 32.1 vs 5.0 months), previous AMI (20.1 vs 4.9 months), previous heart failure (19.5 vs 4.9 months), hypertension (16.6 vs 8.3 months), angina (16.2 vs 5.0 months) and age >65 years (11.3 vs 5.7 months). Given potential treatment switching, the true absolute treatment effect could be underestimated by 28%.ConclusionFor patients with clinically defined heart failure following AMI, ramipril results in a sustained survival benefit, and is associated with an extension of life of up to 14.5 months for, on average, 13 months treatment duration.

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Ventricular conduction abnormalities as predictors of long‐term survival in acute de novo and decompensated chronic heart failure

ESC Heart Failure ◽

10.1002/ehf2.12068 ◽

2015 ◽

Vol 3 (1) ◽

pp. 35-43 ◽

Cited By ~ 5

Author(s):

Heli Tolppanen ◽

Krista Siirila‐Waris ◽

Veli‐Pekka Harjola ◽

David Marono ◽

Jiri Parenica ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

De Novo ◽

Term Survival ◽

Long Term Survival ◽

Conduction Abnormalities ◽

Ventricular Conduction

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Left atrial function index predicts long-term survival in stable outpatients with systolic heart failure

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jew196 ◽

2016 ◽

Vol 18 (2) ◽

pp. 119-127 ◽

Cited By ~ 17

Author(s):

Luis Sargento ◽

Andre Vicente Simões ◽

Susana Longo ◽

Nuno Lousada ◽

Roberto Palma dos Reis

Keyword(s):

Heart Failure ◽

Left Atrial ◽

Systolic Heart Failure ◽

Atrial Function ◽

Left Atrial Function ◽

Term Survival ◽

Long Term Survival ◽

Function Index

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Incidence, Predictors, and Impact of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Military Veterans

Texas Heart Institute Journal ◽

10.14503/thij-15-5532 ◽

2016 ◽

Vol 43 (5) ◽

pp. 397-403 ◽

Cited By ~ 10

Author(s):

Shuab Omer ◽

Lorraine D. Cornwell ◽

Ankur Bakshi ◽

Eric Rachlin ◽

Ourania Preventza ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Artery Bypass ◽

Military Veterans ◽

Survival Rates ◽

Postoperative Atrial Fibrillation ◽

Bypass Grafting ◽

Term Survival ◽

Long Term Survival

Little is known about the frequency and clinical implications of postoperative atrial fibrillation in military veterans who undergo coronary artery bypass grafting (CABG). We examined long-term survival data, clinical outcomes, and associated risk factors in this population. We retrospectively reviewed baseline, intraoperative, and postoperative data from 1,248 consecutive patients with similar baseline risk profiles who underwent primary isolated CABG at a Veterans Affairs hospital from October 2006 through March 2013. Multivariable logistic regression identified predictors of postoperative atrial fibrillation. Kaplan-Meier analysis was used to evaluate long-term survival (the primary outcome measure), morbidity, and length of hospital stay. Postoperative atrial fibrillation occurred in 215 patients (17.2%). Independent predictors of this sequela were age ≥65 years (odds ratios [95% confidence intervals], 1.7 [1.3–2.4] for patients of age 65–75 yr and 2.6 [1.4–4.8] for patients >75 yr) and body mass index ≥30 kg/m2 (2.0 [1.2–3.2]). Length of stay was longer for patients with postoperative atrial fibrillation than for those without (12.7 ± 6.6 vs 10.3 ± 8.9 d; P ≤0.0001), and the respective 30-day mortality rate was higher (1.9% vs 0.4%; P=0.014). Seven-year survival rates did not differ significantly. Older and obese patients are particularly at risk of postoperative atrial fibrillation after CABG. Patients who develop the sequela have longer hospital stays than, but similar long-term survival rates to, patients who do not.

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Long-term outcomes in patients with critical limb ischemia and heart failure with preserved or reduced ejection fraction

Vascular Medicine ◽

10.1177/1358863x17714153 ◽

2017 ◽

Vol 22 (4) ◽

pp. 307-315 ◽

Cited By ~ 6

Author(s):

Kavita B Khaira ◽

Ellen Brinza ◽

Gagan D Singh ◽

Ezra A Amsterdam ◽

Stephen W Waldo ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Left Ventricular ◽

Term Survival ◽

Long Term Survival ◽

Reduced Ejection Fraction ◽

History Of

The impact of heart failure (HF) on long-term survival in patients with critical limb ischemia (CLI) has not been well described. Outcomes stratified by left ventricular ejection fraction (EF) are also unknown. A single center retrospective chart review was performed for patients who underwent treatment for CLI from 2006 to 2013. Baseline demographics, procedural data and outcomes were analyzed. HF diagnosis was based on appropriate signs and symptoms as well as results of non-invasive testing. Among 381 CLI patients, 120 (31%) had a history of HF and 261 (69%) had no history of heart failure (no-HF). Within the HF group, 74 (62%) had HF with preserved ejection fraction (HFpEF) and 46 (38%) had HF with reduced ejection fraction (HFrEF). The average EF for those with no-HF, HFpEF and HFrEF were 59±13% vs 56±9% vs 30±9%, respectively. The likelihood of having concomitant coronary artery disease (CAD) was lowest in the no-HF group (43%), higher in the HFpEF group (70%) and highest in the HFrEF group (83%) ( p=0.001). Five-year survival was on average twofold higher in the no-HF group (43%) compared to both the HFpEF (19%, p=0.001) and HFrEF groups (24%, p=0.001). Long-term survival rates did not differ between the two HF groups ( p=0.50). There was no difference in 5-year freedom from major amputation or freedom from major adverse limb events between the no-HF, HFpEF and HFrEF groups, respectively. Overall, the combination of CLI and HF is associated with poor 5-year survival, independent of the degree of left ventricular systolic dysfunction.

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