Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study

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Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study. / Greve, Anders M.; Gerdts, Eva; Boman, Kurt; Gohlke-Baerwolf, Christa; Rossebo, Anne B.; Nienaber, Christoph A.; Ray, Simon; Egstrup, Kenneth; Pedersen, Terje R.; Kober, Lars; Willenheimer, Ronnie; Wachtell, Kristian.

In: International Journal of Cardiology, Vol. 166, No. 1, 2013, p. 72-76.

Research output: Contribution to journalArticle

Harvard

Greve, AM, Gerdts, E, Boman, K, Gohlke-Baerwolf, C, Rossebo, AB, Nienaber, CA, Ray, S, Egstrup, K, Pedersen, TR, Kober, L, Willenheimer, R & Wachtell, K 2013, 'Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study', International Journal of Cardiology, vol. 166, no. 1, pp. 72-76. https://doi.org/10.1016/j.ijcard.2011.09.064

APA

Greve, A. M., Gerdts, E., Boman, K., Gohlke-Baerwolf, C., Rossebo, A. B., Nienaber, C. A., Ray, S., Egstrup, K., Pedersen, T. R., Kober, L., Willenheimer, R., & Wachtell, K. (2013). Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study. International Journal of Cardiology, 166(1), 72-76. https://doi.org/10.1016/j.ijcard.2011.09.064

CBE

Greve AM, Gerdts E, Boman K, Gohlke-Baerwolf C, Rossebo AB, Nienaber CA, Ray S, Egstrup K, Pedersen TR, Kober L, Willenheimer R, Wachtell K. 2013. Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study. International Journal of Cardiology. 166(1):72-76. https://doi.org/10.1016/j.ijcard.2011.09.064

MLA

Vancouver

Author

Greve, Anders M. ; Gerdts, Eva ; Boman, Kurt ; Gohlke-Baerwolf, Christa ; Rossebo, Anne B. ; Nienaber, Christoph A. ; Ray, Simon ; Egstrup, Kenneth ; Pedersen, Terje R. ; Kober, Lars ; Willenheimer, Ronnie ; Wachtell, Kristian. / Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study. In: International Journal of Cardiology. 2013 ; Vol. 166, No. 1. pp. 72-76.

RIS

TY - JOUR

T1 - Prognostic importance of atrial fibrillation in asymptomatic aortic stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis study

AU - Greve, Anders M.

AU - Gerdts, Eva

AU - Boman, Kurt

AU - Gohlke-Baerwolf, Christa

AU - Rossebo, Anne B.

AU - Nienaber, Christoph A.

AU - Ray, Simon

AU - Egstrup, Kenneth

AU - Pedersen, Terje R.

AU - Kober, Lars

AU - Willenheimer, Ronnie

AU - Wachtell, Kristian

PY - 2013

Y1 - 2013

N2 - Background: The frequency and prognostic importance of atrial fibrillation (AF) in asymptomatic mild-to-moderate aortic stenosis (AS) has not been well described. Methods: Clinical examination, electrocardiography and echocardiography were obtained in asymptomatic patients with mild-to-moderate AS and preserved left ventricular (LV) systolic function, randomized to simvastatin/ezetimibe combination vs. placebo in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. At inclusion, AF was categorized as episodic or longstanding. Rhythm change was assessed on annual in-study electrocardiograms. Impact of AF on cardiovascular morbidity and mortality was determined by adjusting for biomarkers, clinical- and echocardiographic covariates. Results: Mean follow-up was 4.3 +/- 0.8 years (6,721 patient-years of follow-up). At baseline, episodic AF was present in 87 patients (5.6%), longstanding AF in 55 (3.5%) and no AF in 1,421 (90.9%). Incidence of new-onset AF was 1.2%/year; highest in those with impaired LV function. In multivariable analysis, longstanding AF was compared to no AF at baseline, associated with a 4.1-fold higher risk of heart failure (CI 1.2 to 13.8, p = 0.02) and a 4.8-fold higher risk of non-hemorrhagic stroke (CI 1.7 to 13.6, p = 0.003). Conclusion: Rate of AF is moderate in asymptomatic AS. Longstanding but not episodic AF was, independently predictive of increased risk of heart failure and non-hemorrhagic stroke. New-onset AF was associated with cardiac decompensation. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

AB - Background: The frequency and prognostic importance of atrial fibrillation (AF) in asymptomatic mild-to-moderate aortic stenosis (AS) has not been well described. Methods: Clinical examination, electrocardiography and echocardiography were obtained in asymptomatic patients with mild-to-moderate AS and preserved left ventricular (LV) systolic function, randomized to simvastatin/ezetimibe combination vs. placebo in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. At inclusion, AF was categorized as episodic or longstanding. Rhythm change was assessed on annual in-study electrocardiograms. Impact of AF on cardiovascular morbidity and mortality was determined by adjusting for biomarkers, clinical- and echocardiographic covariates. Results: Mean follow-up was 4.3 +/- 0.8 years (6,721 patient-years of follow-up). At baseline, episodic AF was present in 87 patients (5.6%), longstanding AF in 55 (3.5%) and no AF in 1,421 (90.9%). Incidence of new-onset AF was 1.2%/year; highest in those with impaired LV function. In multivariable analysis, longstanding AF was compared to no AF at baseline, associated with a 4.1-fold higher risk of heart failure (CI 1.2 to 13.8, p = 0.02) and a 4.8-fold higher risk of non-hemorrhagic stroke (CI 1.7 to 13.6, p = 0.003). Conclusion: Rate of AF is moderate in asymptomatic AS. Longstanding but not episodic AF was, independently predictive of increased risk of heart failure and non-hemorrhagic stroke. New-onset AF was associated with cardiac decompensation. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

KW - Asymptomatic aortic stenosis

KW - Atrial fibrillation

KW - Outcome

U2 - 10.1016/j.ijcard.2011.09.064

DO - 10.1016/j.ijcard.2011.09.064

M3 - Article

C2 - 21996417

VL - 166

SP - 72

EP - 76

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 1

ER -