Impact of Atrial Fibrillation on Hospitalization Outcomes of Heart Failure in Patients ≥ 60 Years with Implantable Cardioverter Defibrillator
Section snippets
Methods
This study was conducted using the publicly available National Inpatient Sample (NIS) of the Health Care Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality. Information about the registry has been previously described.7
All HF patients aged ≥ 60 who were diagnosed with a history of ICD placement, and were admitted with a primary diagnosis of HF during the years 2016 to 2017 were included (Supplement Table 1). Patients with history of ICD placement were
Results
We included a total of 178,045 patients with a history of HF and ICD placed who were hospitalized for HF symptoms during the years 2016 to 2017. Table 1 summarizes the baseline characteristics of the study population. Patients with AF accounted for 56.2% of the total study population. Patients with AF were older with median age (75 vs 72 years, SMD=0.3) had less proportion of females (26.7% vs 32.3% SMD=0.1), higher proportions of white race (71.4% vs 57.4%, SMD=0.3) and had higher prevalence
Discussion
The key findings in this study are: 1. AF is highly prevalent in hospitalized older patients with HF and ICDs. 2. AF is an independent predictor for increased all-cause in-hospital mortality and cardiogenic shock. 3. This increased risk for mortality and cardiogenic shock is age dependent, and counter-intuitively, risk decreases with advancing age and essentially becomes insignificant in patients older than 75 years. Perhaps this relationship can be explained by an increase in competing risks
Authors contribution
AA: Conceptualization, Methodology, Resources, Formal analysis, Visualization, Writing, review & eiditing.
AE, AO, HA: Writing - review & editing.
MA: Formal analysis, review & editing
AV: Supervision, Methodology, Writing review & editing.
Disclosure
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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