Does atrial fibrillation deteriorate the prognosis in patients with septic or cardiogenic shock?

• Verfasst von: Schupp, Tobias [VerfasserIn]
• Verfasst von: Forner, Jan [VerfasserIn]
• Verfasst von: Rusnak, Jonas [VerfasserIn]
• Verfasst von: Weidner, Kathrin [VerfasserIn]
• Verfasst von: Egner-Walter, Sascha [VerfasserIn]
• Verfasst von: Ruka, Marinela [VerfasserIn]
• Verfasst von: Dudda, Jonas [VerfasserIn]
• Verfasst von: Jawhar, Schanas [VerfasserIn]
• Verfasst von: Brück, Lea Marie [VerfasserIn]
• Verfasst von: Dulatahu, Floriana [VerfasserIn]
• Verfasst von: Bertsch, Thomas [VerfasserIn]
• Verfasst von: Müller, Julian [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Does atrial fibrillation deteriorate the prognosis in patients with septic or cardiogenic shock?
• Verf.angabe: Tobias Schupp, MD, Jan Forner, MS, Jonas Rusnak, MD, Kathrin Weidner, MD, Sascha Egner-Walter, MS, Marinela Ruka,MD, Jonas Dudda, MS, Schanas Jawhar, MS, Lea Marie Brück, MS, Floriana Dulatahu, MS, Thomas Bertsch, MD, Julian Müller, MD, Michael Behnes, MD and Ibrahim Akin, MD
• E-Jahr: 2023
• Jahr: 15 October 2023
• Umfang: 9 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 18. August 2023 ; Gesehen am 28.11.2023
• Titel Quelle: Enthalten in: The American journal of cardiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1958
• Jahr Quelle: 2023
• Band/Heft Quelle: 205(2023) vom: Okt., Seite 141-149
• ISSN Quelle: 1879-1913
• DOI: doi:10.1016/j.amjcard.2023.07.008
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: atrial fibrillation
• Sach-SW: cardiogenic shock
• Sach-SW: mortality
• Sach-SW: sepsis
• Sach-SW: septic shock
• K10plus-PPN: 1871482100

Abstract

Atrial fibrillation (AF) is associated with increased risk of mortality in various clinical conditions. However, the prognostic role of preexisting and new-onset AF in critically ill patients, such as patients with septic or cardiogenic shock remains unclear. This study investigates the prognostic impact of preexisting and new-onset AF on 30-day all-cause mortality in patients with septic or cardiogenic shock. Consecutive patients with sepsis, or septic or cardiogenic shock were enrolled in 2 prospective, monocentric registries from 2019 to 2021. Statistical analyses included Kaplan-Meier, multivariable logistic, and Cox proportional regression analyses. In total, 644 patients were included (cardiogenic shock: n = 273; sepsis/septic shock: n = 361). The prevalence of AF was 41% (29% with preexisting AF, 12% with new-onset AF). Within the entire study cohort, neither preexisting AF (log-rank p = 0.542; hazard ratio [HR] 1.075, 95% confidence interval [CI] 0.848 to 1.363, p = 0.551) nor new-onset AF (log-rank p = 0.782, HR = 0.957, 95% CI 0.683 to 1.340, p = 0.797) were associated with 30-day all-cause mortality compared with non-AF. In patients with AF, ventricular rates >120 beats/min compared with ≤120 beats/min were shown to increase the risk of reaching the primary end point in AF patients with cardiogenic shock (log-rank p = 0.006, HR 1.886, 95% CI 1.164 to 3.057, p = 0.010). Furthermore, logistic regression analyses suggested increased age was the only predictor of new-onset AF (odds ratio 1.042, 95% CI 1.018 to 1.066, p = 0.001). In conclusion, neither the presence of preexisting AF nor the occurrence of new-onset AF was associated with the risk of 30-day all-cause mortality in consecutive patients admitted with cardiogenic shock.