Effects of Atrial Fibrillation on Long-Term Outcomes in Patients Hospitalized for Heart Failure in Japan - A Report From the Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD)

Background: Atrial fibrillation (AF) is a common arrhythmia in patients with heart failure (HF), but its prognostic importance is controversial. The effect of AF on long-term outcomes, including mortality and rehospitilization, among unselected HF patients hospitalized with HF in routine clinical practice in Japan was assessed in the present study. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) prospectively studied the characteristics and treatment strategies of a broad sample of patients hospitalized with worsening HF and the outcomes were followed with an average of 2.4 years of follow-tip The Study cohort (n=2,659) was according to the presence (n=937; 35.2%) or absence (n=1,71.2, 64.8%) of AF at baseline. After multivariable adjustment, patients with and without AF had a comparable risk for all-cause death (adjusted hazard ratio (HR) 0.931, 95% confidence interval (CI) 0.690-1.259. P=0.643), cardiac death (adjusted HR 0.949, 95%CI 0.655-1.377. P=0.784). rehospitalization because of the worsening HF (adjusted HR 1.028, 95%CI 0.816-1.295. P=0.816), and all-cause death or rehospitalization (adjusted HR 1.039, 95%CI 0.842-1.281, P=0.721). Conclusions: Among patients hospitalized for HF in Japan, AF was common. but was not all independent risk for long-term adverse outcomes, including death or rehospitalization. in routine clinical practice. (Circ J 2009: 73: 2084-2090)