| Abstract | Objectives: Heart failure (HF) and atrial fibrillation (AF) are two distinct but related entities and their coexistence create a very dangerous interaction. The aim of this study was to determine the differences in clinical characteristics and selected parameters between HF patients with and without AF.
Patients and Methods: This was a cross-sectional study, that included a total of 90 patients that presented with signs and symptoms of heart failure at the emergency department. Patients were enrolled in a 1:1 ratio in terms of sex, had to be New York Heart Association (NYHA) functional class II-IV. Data were analyzed by using SPSS Statistics for Windows® (version 25.0, IBM, Armonk, NY, USA).
Results: There was no significant difference in anthropometric and clinical parameters among studied groups, except in age (72.7±9.1 in FA group vs. 67.3±11.0 years in non-FA group, P=0.012), systolic blood pressure values (131.2±21.9 in FA group vs. 143.5±32.5 mmHg in non-FA group, P=0.035) and heart rate (103.0±32.0 in FA group vs. 84.0±26.0 in non-FA group, P=0.003). Moreover, there was no statistical difference in baseline laboratory findings between groups, except for activated partial thromboplastin time (30±8 in FA group vs. 25±3 seconds in non-FA group, P=0.001), prothrombin time-international normalized ratio (1.7±1.0 in FA group vs. 1.1±0.3 in non-FA group, P=0.001) and albumin values (37±4.0 in FA group vs. 39±4.0 g/L in non-FA group, P=0.043). Furthermore, patients with HF and AF use more beta blocker (49, 98.0% vs. 32, 80.0%, P=0.009), digoxin (16, 32.0% vs. 2, 5.0%, P=0.001) and anticoagulants (42, 84.0% vs. 3, 7.5%, P<0.001), as well as less acetylsalicylic acid (27, 67.5% vs. 8, 16.0%, P<0.001), while there was no statistical difference in other medications. Among HF patients, group without AF had significantly higher prevalence of anemia (16, 40.0% vs. 10, 20.0%, P=0.038) in comparison to group with AF, while there was no difference in the prevalence of other comorbidities. Finally, there was no statistical difference in echocardiographic parameters between studied groups.
Conclusion: There is no major difference in clinical characteristics, NYHA class and hospitalization rate between patients with HF and AF compared to patients with HF and without AF. However, patients with HF and without AF have higher prevalence of anemia and acetylsalicylic acid use compared to patients with HF and AF. |
| Abstract (croatian) | Ciljevi: Zatajenje srca (HF) i fibrilacija atrija (AF) dva su različita, ali povezana entiteta i njihova istodobna prisutnost stvara vrlo opasnu interakciju. Cilj ovog istraživanja bio je utvrditi razlike u kliničkim obilježjima i odabranim parametrima između HF bolesnika s AF i bez AF.
Pacijenti i metode: Ovo je presječno istraživanje koje je uključivalo ukupno 90 bolesnika sa simptomima zatajenja srca na hitnoj službi. Pacijenti su bili uključeni u omjeru 1: 1 s obzirom na spol, a morali su pripadati klasi II-IV prema New York Heart udruženju (NYHA). Podaci su analizirani uz pomoć SPSS Statistics for Windows® (verzija 25.0, IBM, Armonk, NY, USA).
Rezultati: Nije bilo značajne razlike u antropometrijskim i kliničkim parametrima među skupinama, osim u dobi (72,7±9,1 u skupini FA naspram 67,3±11,0 godina u ne-FA skupini, P=0,012), vrijednostima sistoličkog krvnog tlaka (131,2±21,9 u FA skupini naspram 143,5±32,5 mmHg u ne-FA skupini, P=0,035) i otkucajima srca (103,0±32,0 u FA skupini naspram 84,0±26,0 u ne-FA skupini, P=0,003). Štoviše, nije bilo statističke razlike u osnovnim laboratorijskim nalazima između skupina, osim za vrijednosti aktiviranog parcijalnog tromboplastinskog vremena (30±8 u FA skupini naspram 25±3 sekundi u ne-FA skupini, P=0,001), protrombinskog vremena - međunarodnog normaliziranog omjera (1,7±1,0 u FA skupini naspram 1,1±0,3 u ne-FA skupini, P=0,001) i albumina (37±4,0 u FA skupini naspram 39±4,0 g/L u ne-FA skupini, P=0,043). Nadalje, bolesnici s HF i AF koriste više beta blokatora (49, 98,0% naspram 32, 80,0%, P=0,009), digoksina (16, 32,0% naspram 2, 5,0%, P=0,001) i antikoagulansa (42, 84,0% naspram 3, 7,5%, P<0,001), kao i manje acetilsalicilne kiseline (27, 67,5% naspram 8, 16,0%, P<0,001), dok nema statističke razlike u drugim lijekovima. Kod HF bolesnika, skupina bez AF imala je značajno veću prevalenciju anemije (16, 40,0% naspram 10, 20,0%, P=0,038) u usporedbi s skupinom s AF, dok nije bilo razlike u učestalosti drugih komorbiditeta. Konačno, nije bilo statističke razlike u ehokardiografskim parametrima između ispitivanih skupina. |
