A Meta-Analysis of the Prognostic Significance of Atrial Fibrillation in Chronic Heart Failure
Open accessAbstract
Aims: Atrial fibrillation (AF) is one of the commonest sustained arrhythmias in chronic heart failure (CHF), although the prognostic implications of the presence of AF in CHF remain controversial. We have therefore performed this meta-analysis to study the effects of the presence of AF on mortality in CHF patients. Methods and results: A systematic MEDLINE search for all randomized trials and observational studies in which the influence of AF on CHF mortality was investigated and meta-analysis of the mortality data was performed. A total of 16 studies were identified of which 7 were randomized trials and 9 were observational studies including 30 248 and 23 721 patients, respectively. An adjusted meta-analysis of the data revealed that the presence of AF is associated with an adverse effect on total mortality with an odds ratio (OR) of 1.40 [95% confidence interval (CI) 1.32–1.48, P < 0.0001] in randomized trials and an OR of 1.14 (95% CI 1.03–1.26, P < 0.05) in observational studies. This increase in mortality associated with the presence of AF was observed in subgroups of CHF patients with both preserved and impaired left ventricular (LV) systolic function. Conclusion: In conclusion, meta-analysis of 16 studies involving 53 969 patients suggests that the presence of AF is associated with an adverse prognosis in CHF irrespective of LV systolic function.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The text we found for this paper looks like another document, so the self-check wasn’t run.
Cites
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
The SOLVD Investigators* (1991) · New England Journal of Medicine · doi:10.1056/nejm199108013250501 · Cited by 8,029 · see citing works
Effects of Enalapril on Mortality in Severe Congestive Heart Failure
The Consensus Trial Study Group* (1987) · New England Journal of Medicine · doi:10.1056/nejm198706043162301 · Cited by 5,109 · see citing works
Moher, D., Cook, D. J., Eastwood, S., Olkin, I., Rennie, D., & Stroup, D. F. (1999) · The Lancet · doi:10.1016/s0140-6736(99)04149-5 · Cited by 4,826 · see citing works
Swedberg, K. B., & KJEKSHUS, J. K. (1988) · The American Journal of Cardiology · doi:10.1016/s0002-9149(88)80087-0 · Cited by 3,762 · see citing works
Rhythm control versus rate control for atrial fibrillation and heart failure
Roy, D., Talajic, M., Nattel, S., Wyse, D. G., Dorian, P., Lee, K. L., Bourassa, M. G., Arnold, J. M. O., Buxton, A. E., Camm, A. J., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0708789 · Cited by 1,585 · see citing works
Cleland, J. G. F. (2003) · European Heart Journal · doi:10.1016/s0195-668x(02)00823-0 · Cited by 1,551 · see citing works
Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy
Maisel, W. H., & Stevenson, L. W. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(02)03373-8 · Cited by 967 · see citing works
Dries, D. L., Exner, D., Gersh, B., DOMANSKI, M. J., Waclawiw, M. A., & Stevenson, L. W. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00297-6 · Cited by 963 · see citing works
Swedberg, K., Olsson, L. G., Charlesworth, A., Cleland, J., Hanrath, P., Komajda, M., Metra, M., Torp-Pedersen, C., & Poole-Wilson, P. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi166 · Cited by 647 · see citing works
Hemodynamic Effects of an Irregular Sequence of Ventricular Cycle Lengths During Atrial Fibrillation
Clark, D. M., Plumb, V. J., Epstein, A. E., & Kay, G. N. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00254-4 · Cited by 610 · see citing works
Prognostic significance of atrial fibrillation in advanced heart failure. A study of 390 patients.
Middlekauff, H. R., Stevenson, W. G., & Stevenson, L. W. (1991) · Circulation · doi:10.1161/01.cir.84.1.40 · Cited by 576 · see citing works
Olsson, L. G., Swedberg, K., Ducharme, A., Granger, C. B., Michelson, E. L., McMurray, J. J. V., Puu, M., Yusuf, S., & Pfeffer, M. A. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.01.060 · Cited by 574 · cited 4× · see citing works
“Similarly data from the CHARM cohort of patients suggest that baseline AF is associated with an increased risk of all-cause mortality, hospitalization, cardiovascular (CV) death/ hospitalization, and fatal/non-fatal strokes.(10)”
BackgroundMethodResultInfluentialPedersen, O. D., Bagger, H., Keller, N., Marchant, B., Køber, L., & Torp-Pedersen, C. (2001) · Circulation · doi:10.1161/01.cir.104.3.292 · Cited by 496 · see citing works
Carson, P. E., Johnson, G. R., Dunkman, W. B., Fletcher, R. D., Farrell, L., & Cohn, J. N. (1993) · PubMed · Cited by 319 · see citing works
Pozzoli, M., Cioffi, G., Traversi, E., Pinna, G. D., Cobelli, F., & Tavazzi, L. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00221-6 · Cited by 303 · see citing works
Crijns, H. J. G. M. (2000) · European Heart Journal · doi:10.1053/euhj.1999.2107 · Cited by 259 · see citing works
Improving survival for patients with atrial fibrillation and advanced heart failure
Stevenson, W. G., Stevenson, L. W., Middlekauff, H. R., Fonarow, G. C., Hamilton, M. A., Woo, M. A., Saxon, L. A., Natterson, P. D., Steimle, A. E., Walden, J. A., et al. (1996) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(96)00358-0 · Cited by 218 · see citing works
Mathew, J., Hunsberger, S., Fleg, J. L., Sherry, F. M., Williford, W. O., & Yusuf, S. (2000) · CHEST Journal · doi:10.1378/chest.118.4.914 · Cited by 139 · see citing works
Rivero‐Ayerza, M., Reimer, W. J. M. S. O., Lenzen, M. J., Theuns, D. A. M. J., Jordaens, L. J. L. M., Michel Komajda, N., Folláth, F., Swedberg, K. B., & Cleland, J. G. F. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn217 · Cited by 134 · see citing works
Mahoney, P. D., Kimmel, S., DeNofrio, D., Wahl, P. M., & Loh, E. (1999) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)00144-7 · Cited by 133 · see citing works
Atrial fibrillation, ischaemic heart disease, and the risk of death in patients with heart failure
Pedersen, O. D., Søndergaard, P., Nielsen, T., et al. (2006) · European Heart Journal · doi:10.1093/eurheartj/ehl359 · Cited by 79 · see citing works
Corell, P., Gustafsson, F., Schou, M., Markenvard, J., Nielsen, T., & Hildebrandt, P. R. (2006) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2006.08.004 · Cited by 77 · see citing works
Ahmed, A., Thornton, P. L., Perry, G. J., Allman, R. M., & DeLong, J. F. (2004) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2003.11.011 · Cited by 60 · see citing works
Ruşinaru, D., Leborgne, L., Peltier, M., & Tribouilloy, C. M. (2008) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2008.04.002 · Cited by 49 · see citing works
Prognostic Significance of Atrial Fibrillation is a Function of Left Ventricular Ejection Fraction
Pai, R. G., & Varadarajan, P. (2007) · Clinical Cardiology · doi:10.1002/clc.20107 · Cited by 46 · see citing works
Wojtkowska, I., Sobkowicz, B., Musial, W. J., & Kożuch, M. (2006) · PubMed · Cited by 13 · see citing works
Mathew, J., Hunsberger, S., Fleg, J. L., et al. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)81588-x · Cited by 6 · see citing works
Burden of asymptomatic episodes of atrial fibrillation in a heart failure cohort
Caldwell, J. R., Contractor, H., Garratt, C., et al. (2008) · European Journal of Heart Failure Supplements · doi:10.1016/s1567-4215(08)60443-9 · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000485 · Cited by 12,591 · see citing works
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175 · see citing works
Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036 · see citing works
Heart disease and stroke statistics-2018 update: a report from the american heart association
Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., Chiuve, S. E., Cushman, M., Delling, F. N., Deo, R., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000558 · Cited by 7,146 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Heart Disease and Stroke Statistics—2015 Update: A Report From the American Heart Association
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., de Ferranti, S., Després, J.-P., Fullerton, H. J., Howard, V. J., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000152 · Cited by 5,797 · see citing works
Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association
Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., Fox, C. S., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31828124ad · Cited by 5,292 · see citing works
Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study
Chugh, S. S., Havmoeller, R., Narayanan, K., Singh, D., Rienstra, M., Benjamin, E. J., Gillum, R. F., Kim, Y.-H., McAnulty, J. H., Zheng, Z.-J., et al. (2014) · Circulation · doi:10.1161/circulationaha.113.005119 · Cited by 4,506 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933 · see citing works
Global epidemiology of atrial fibrillation
Rahman, F., Kwan, G. F., & Benjamin, E. J. (2014) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2014.118 · Cited by 731 · see citing works
Ezekowitz, J. A., O'Meara, E., McDonald, M. A., Abrams, H., Chan, M., Ducharme, A., Giannetti, N., Grzeslo, A., Hamilton, P. G., Heckman, G. A., et al. (2017) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2017.08.022 · Cited by 676 · see citing works
Kotecha, D., Holmes, J., Krum, H., Altman, D. G., Manzano, L., Cleland, J. G. F., Lip, G. Y. H., Coats, A. J. S., Andersson, B., Kirchhof, P., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61373-8 · Cited by 579 · see citing works
Ziff, O. J., Lane, D. A., Samra, M., Griffith, M., Kirchhof, P., Lip, G. Y. H., Steeds, R. P., Townend, J., & Kotecha, D. (2015) · BMJ · doi:10.1136/bmj.h4451 · Cited by 341 · see citing works
Kotecha, D., Chudasama, R., Lane, D. A., Kirchhof, P., & Lip, G. Y. H. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.10.220 · Cited by 199 · see citing works
Manolis, A. J., Rosei, E. A., Coca, A., Cifkova, R., Erdine, S. E., Kjeldsen, S., Lip, G. Y. H., Narkiewicz, K., Parati, G., Redon, J., et al. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e32834f03bf · Cited by 198 · see citing works
Senoo, K., Lip, G. Y. H., Lane, D. A., Büller, H. R., & Kotecha, D. (2015) · Stroke · doi:10.1161/strokeaha.115.009487 · Cited by 64 · see citing works
- Authors
- Mamas, M. A., Caldwell, J. C., Chacko, S., Garratt, C. J., Fath-Ordoubadi, F., & Neyses, L.
- Affiliations
- Manchester Royal Infirmary (GB)
- Manchester Heart Centre, Manchester Royal Infirmary , Oxford Road, Manchester, M13 9WL ,
- Corresponding author
- Mamas, Mamas A.
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-06-24
- Volume
- 11
- Issue
- 7
- Pages
- 676-683
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W2023008577
- Cited by
- 393
- References
- 29
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 36 · 2023: 26 · 2022: 26 · 2021: 27 · 2020: 41 · 2019: 29 · 2018: 26 · 2017: 23 · 2016: 29 · 2015: 28 · 2014: 17 · 2013: 14 · 2012: 18
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- green
- orbilu.uni.lu
- Licence
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Open Repository and Bibliography (University of Luxembourg) (submittedVersion, cc-by-nc-sa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- atrial fibrillation, chronic heart failure, mortality, prognosis, left ventricular systolic function, preserved ejection fraction, cardiac arrhythmias
- MeSH terms
- Aged, Atrial Fibrillation, Female, United Kingdom, Heart Failure, Humans, Male, Middle Aged, Prognosis, Multivariate Analysis, Confidence Intervals, Odds Ratio, Randomized Controlled Trials as Topic, Ventricular Function, Left, Risk Assessment, Heart Failure, Systolic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
