The Predictors Of Prognosis Of Patients With Atrial Fibrillation And Heart Failure

Objective:To investigate the predictors of prognosis of patients with atrial fibrillation(AF) and heart failure(HF).Methods:We recruited a set of consecutive patients with HF (LVEF<0.4) and AF between 2013 and 2015 inFuWai Hospital. Their clinical outcomes were follow up once per six months, and multivariate Cox regression analysis was performed to determinate the independent risk factors of all-cause mortality and heart transplant.Results:A total of 73 consecutive individuals with HF and AF were included in this study. During(16.8±10.19)months follow-up,24 patients died (32.9%),4 patients had a heart transplant(8.21%), the total rate of clinical events was 41.1%. Significant differences were observed in NYHA classes Ⅲand Ⅳ, hypertension history, right ventricular diameters, levels of bilirubin, NT-pro-BNP, and use of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) between patients with and without clinical events (all P<0.05). The multivariate Cox regression analysis showed that high level of bilirubin and low level of hemoglobin, were independently related to increased risk of clinical events. Use of ACEIs and β-blocker was a protective factor for clinical outcomes.Conclusions:Atrial fibrillation in patients with heart failure has increased risk of clinical events. The use of ACEIs and ARBs, high level of bilirubin and low level of hemoglobin might have impact on the prognosis of patients with both heart failure and atrial fibrillation.