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Recommended Drug Therapy Low in A-Fib, Heart Failure

Last Updated: May 01, 2009.

Patients with atrial fibrillation and heart failure may be undertreated, and such patients have a higher mortality risk than those with only atrial fibrillation, according to research published in the May 5 issue of the Journal of the American College of Cardiology.

FRIDAY, May 1 (HealthDay News) -- Patients with atrial fibrillation and heart failure may be undertreated, and such patients have a higher mortality risk than those with only atrial fibrillation, according to research published in the May 5 issue of the Journal of the American College of Cardiology.

Robby Nieuwlaat, Ph.D., of the University Hospital Maastricht in the Netherlands, and colleagues analyzed data from 5,333 adults with atrial fibrillation, of whom 1,816 also had heart failure at baseline. Patients were surveyed at one-year follow-up.

In patients with both conditions, the recommended therapy for heart failure with left ventricular systolic dysfunction (LVSD) was prescribed in 40 percent of patients, and recommended drug therapy for both LVSD-heart failure and atrial fibrillation was used in 29 percent, the researchers report. Heart failure patients had a higher risk of mortality (9.5 versus 3.3 percent) and progression of atrial fibrillation (35 versus 19 percent) than those without heart failure.

"This analysis of the Euro Heart Survey on atrial fibrillation provides a unique and comprehensive overview of patient characteristics, treatment, and outcome of patients who have both heart failure and atrial fibrillation. Our analysis confirms that patients with combined atrial fibrillation and heart failure have a grim prognosis with a one-year mortality of 9.5 percent and worsening of heart failure in almost 25 percent. These patients might be severely undertreated, with regard to drug therapy for stroke prevention, heart failure therapy, and rate control," the authors write.

The study was supported by AstraZeneca, Sanofi-Aventis, and Eucomed. Two co-authors disclosed financial relationships with relevant companies.

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