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Bidirectional association between atrial fibrillation and congestive heart failure in the elderly

Wesley T O'Neal1, Waqas Qureshi, Zhu-Ming Zhang

  • 1aDepartment of Internal Medicine bDepartment of Internal Medicine, Section on Cardiology cEpidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|January 31, 2016
PubMed

Insights

This study reveals a two-way link between atrial fibrillation and congestive heart failure (CHF) in older adults. Each condition increases the risk of developing the other, highlighting a significant bidirectional relationship.

Area of Science:

  • Cardiology
  • Gerontology
  • Epidemiology

Background:

  • Atrial fibrillation and congestive heart failure (CHF) are common cardiovascular conditions in older adults.
  • The relationship between these two conditions is complex and may be bidirectional.

Purpose of the Study:

  • To investigate the bidirectional association between atrial fibrillation and congestive heart failure (CHF) in an elderly cohort.
  • To determine if atrial fibrillation predicts incident CHF and if CHF predicts incident atrial fibrillation.

Main Methods:

  • The Cardiovascular Health Study (CHS) cohort was analyzed, including over 5000 participants.
  • Cox regression models were used to assess the risk of developing one condition in the presence of the other.
  • Incident cases of atrial fibrillation and CHF were identified through electrocardiograms, hospitalizations, and medical records.

Main Results:

  • Congestive heart failure (CHF) was associated with a 2-fold increased risk of developing atrial fibrillation (HR 2.0, 95% CI 1.4-3.0).
  • Atrial fibrillation was associated with a 1.9-fold increased risk of developing CHF (HR 1.9, 95% CI 1.5-2.2).
  • These associations remained significant after adjusting for relevant covariates.

Conclusions:

  • A significant bidirectional relationship exists between atrial fibrillation and congestive heart failure (CHF).
  • Each condition appears to independently increase the risk of developing the other condition in older adults.
  • These findings underscore the importance of managing both conditions concurrently.
Abstract

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