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Russian Registry of Patients with Chronic Heart Failure and Atrial Fibrillation (RIF-CHF): Clinical and demographic characteristics of the sample upon inclusion into the Registry

Tereshchenko S. N., Romanova N. V., Zhirov I. V., Osmolovskaya Yu. F., Golitsyn S. P.
Federal State Budgetary Institution, "Russian Cardiology Science and Production Center" of the Ministry of Health of the Russian Federation, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: CHF, atrial fibrillation, epidemiology, anticoagulant therapy

DOI: 10.18087/rhfj.2016.6.2276

Background. Chronic heart failure (CHF) and atrial fibrillation (AF) are the most common conditions in clinical practice. CHF and AF are often associated with each other. Aim. To evaluate the degree of compliance with clinical guidelines and prevalence of long‑term anticoagulant therapy (ACT) in this group of patients in Russia. Materials and methods. From February through December 2015, 1003 patients with CHF in combination with AF were included in the multicenter, prospective, cohort study (Registry of Patients with CHF and AF, RIF‑CHF). The major etiologic factors of CHF in the study population were ischemic heart disease (48.7%) and arterial hypertension (30.2%). Results. Prevalence of long‑term ACT was 64% for the total study population. In the group of moderate risk for thromboembolic complications (TEC) (CHA2DS2VASc scale score 1), 81% of patients received the anticoagulant therapy; 69% of patients with TEC risk score 2 received ACT; and in the high‑risk group (score ≥3), 58% of patients received the anticoagulant therapy. Conclusion.Results of RIF‑CHF showed insufficient prevalence of recommended therapy for CHF and low prevalence of long‑term ACT, particularly in the group of high risk for TEC.
  1. Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol. 1993 Oct;22 (4 Suppl A): 6A‑13A.
  2. MacIntyre K, Capewell S, Stewart S, Chalmers JW, Boyd J, Finlayson A et al. Evidence of improving prognosis in heart failure: trends in case fatality in 66 547 patients hospitalized between 1986 and 1995. Circulation. 2000 Sep 5;102 (10):1126–31.
  3. Mosterd A, Cost B, Hoes AW, de Bruijne MC, Deckers JW, Hofman A, Grobbee DE. The prognosis of heart failure in the general population: The Rotterdam study. Eur Heart J. 2001 Aug;22 (15):1318–27.
  4. Cowie MR , Wood DA, Coats AJ, Thompson SG, Suresh V, Poole‑Wilson PA, Sutton GC. Survival of patients with a new diagnosis of heart failure: a population based study. Heart. 2000 May;83 (5):505–10.
  5. Агеев Ф.Т., Даниелян М.О., Мареев В.Ю., Беленков Ю.Н. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения (по материалам исследования ЭПОХА‑О‑ХСН). Журнал Сердечная Недостаточность. 2004;5 (1):4–7 [Ageev F.T., Danielyan M.O., Mareev V.Yu., Belenkov Yu.N. Bol`ny`e s xronicheskoj serdechnoj nedostatochnost`yu v rossijskoj ambulatornoj praktike: osobennosti kontingenta, diagnostiki i lecheniya (po materialam issledovaniya E`POXA‑O‑XSN). Zhurnal Serdechnaya Nedostatochnost`. 2004;5 (1):4–7].
  6. Агеев Ф.Т., Беленков Ю.Н., Фомин И.В., Мареев В.Ю., Бадин Ю.В., Галявич А.С. и др. Распространенность хронической сердечной недостаточности в Европейской части Российской Федерации – данные ЭПОХА–ХСН. Журнал Сердечная Недостаточность. 2006;7 (3):112–5 [Ageev F.T., Belenkov Yu.N., Fomin I.V., Mareev V.Yu., Badin Yu.V., Galyavich A.S. i dr. Rasprostranennost` xronicheskoj serdechnoj nedostatochnosti v Evropejskoj chasti Rossijskoj Federaczii – danny`e E`POXA‑XSN. Zhurnal Serdechnaya Nedostatochnost`. 2006;7 (3):112–5].
  7. Фомин И.В. Артериальная гипертония в Российской Федерации – последние 10 лет. Что дальше? Сердце: журнал для практикующих врачей. 2007;6 (3):120–3 [Fomin I.V. Arterial`naya gipertoniya v Rossijskoj Federaczii – poslednie 10 let. Chto dal`she? Serdcze: zhurnal dlya praktikuyushhix vrachej. 2007;6 (3):120–3].
  8. Chugh SS, Havmoeller R , Narayanan K, Singh D, Rienstra M, Benjamin EJ et al. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study. Circulation. 2014 Feb 25;129 (8):837–47.
  9. Lloyd‑Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004 Aug 31;110 (9):1042–6.
  10. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998 Sep 8;98 (10):946–52.
  11. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003 Jun 17;107 (23):2920–5.
  12. The SOLVD Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med. 1992 Sep 3;327 (10):685–91.
  13. CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987 Jun 4;316 (23):1429–35.
  14. Gomez‑Outes A, Terleira‑Fernandez AI, CalvoRojas G, Suarez‑Gea ML, VargasCastrillon E. Dabigatran, rivaroxaban, or apixaban versus warfarinin patients with nonvalvular atrial fibrillation: a systematic review and meta‑analysis of subgroups. Thrombosis. 2013;2013:640723.
  15. Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology and rationale for therapy. Am J Cardiol. 2003 Mar 20;91 (6A): 2D‑8D.
  16. Savelieva I, John Camm A. Atrial fibrillation and heart failure: natural history and pharmacological treatment. Europace. 2004 Sep;5 (Suppl 1):S5–19.
  17. Heist EK, Ruskin JN. Atrial fibrillation and congestive heart failure: risk factors, mechanisms and treatment. Prog Cardiovasc Dis. 2006 Jan‑Feb;48 (4):256–69.
  18. Anter E, Jessup M, Callans DJ. Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation. 2009 May 12;119 (18):2516–25.
  19. Sanoski CA. Prevalence, pathogenesis, and impact of atrial fibrillation. Am J Health Syst Pharm. 2010 May 1;67 (9 Suppl 5):S11–6.
  20. Potpara TS, Stankovic GR , Beleslin BD, Polovina MM, Marinkovic JM, Ostojic MC, Lip GY. A12‑year follow-up study of patients with newly diagnosed lone atrial fibrillation: implications of arrhythmia progression on prognosis: The Belgrade Atrial Fibrillation study. Chest. 2012 Feb;141 (2):339–47.
  21. Badano LP, Di Lenarda A, Bellotti P, Albanese MC, Sinagra G, Fioretti PM. Patients with chronic heart failure encountered in daily clinical practice are different from the «typical» patient enrolled in therapeutic trials. Ital Heart J. 2003 Feb;4 (2):84–91.
  22. Cleland JG, Swedberg K, Follath F, Komajda M, Cohen‑Solal A, Aguilar JC et al. The EuroHeart Failure survey programme – a survey on the quality of care among patients with heart failure in Europe. Part I: patient characteristics and diagnosis. Eur Heart J. 2003 Mar;24 (5):442–63.
  23. Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP et al. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur Heart J. 2006 Nov;27 (22):2725–36.
  24. Maggioni AP, Dahlström U, Filippatos G, Chioncel O, Leiro MC, Drozdz J et al. EURObservational Research Programme: the heart failure pilot survey (ESC‑HF Pilot). Eur J Heart Fail. 2010 Oct;12(10):1076–84.
  25. Pulignano G, Del Sindaco D, Tavazzi L, Lucci D, Gorini M, Leggio F et al. Clinical features and outcomes of elderly outpatients with heart failure followed up in hospital cardiology units: data from a large nationwide cardiology database (INCHF Registry). Am Heart J. 2002 Jan;143 (1):45–55.
  26. Muntwyler J, CohenSolal A, Freemantle N, Eastaugh J, Cleland JG, Follath F. Relation of sex, age and concomitant diseases to drug prescription for heart failure in primary care in Europe. Eur J Heart Fail. 2004 Aug;6 (5):663–8.
  27. Yancy CW, Fonarow GC, Albert NM, Curtis AB, Strough WG, Gheorghiade M et al. Adherence to guidelinerecommended adjunctive heart failure therapies among outpatient cardiology practices (findings from IMPROVE HF). Am J Cardiol. 2010 Jan 15;105 (2):255–60.
  28. Tsutsui H, TsuchihaschiMakaya M, Kinugawa S, Goto D, Takeshita A. Characteristics and outcomes of patient with heart failure in general practices and hospitals. Circ J. 2007 Apr;71 (4):449–54.
  29. Lenzen MJ, Scholte op Reimer WJ, Boersma E, Vantrimpont PJ, Follath F, Swedberg K et al. Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey. Eur Heart J. 2004 Jul;25 (14):1214–20.
  30. Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC. Clinical presentation, management, and in‑hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) database. J Am Coll Cardiol. 2006 Jan 3;47 (1):76–84.
  31. Nieuwlaat R , Eurlings LW, Cleland JG, Cobbe SM, Vardas PE, Capucci A et al. Atrial fibrillation and heart failure in cardiology practice: reciprocal impact and combined management from the perspective of atrial fibrillation: results of the Euro Heart Survey on atrial fibrillation. J Am Coll Cardiol. 2009 May 5;53 (18):1690–8.
  32. De Ferrari GM, Klersy C, Ferrero P, Fantoni C, Salerno‑Uriarte D, Manca L et al. Atrial fibrillation in heart failure patients: prevalence in daily practice and effect on the severity of symptoms. Data from the ALPHA study registry. Eur J Heart Fail. 2007 May;9 (5):502–9.
  33. Hamaguchi S, Yokoshiki H, Kinugawa S, Tsuchihashi‑Makaya M, Yokota T, Takeshita A, Tsutsui H. 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 (JCARECARD). Circ J. 2009 Nov;73 (11):2084–90.
  34. Rewiuk K, Wizner B, Fedyk‑Łukasik M, Zdrojewski T, Opolski G, Dubiel J et al. Epidemiology and management of coexisting heart failure and atrial fibrillation in an outpatient setting. Pol Arch Med Wewn. 2011 Nov;121 (11):392–9.
  35. Ceia F, Fonseca C, Mota T, Morais H, Matias F, Costa C, Oliveira AG. Aetiology, comorbitidy and drug therapy of chronic heart failure in the real world: the EPICA substudy. Eur J Heart Fail. 2004 Oct;6 (6):801–6.
  36. Baldasseroni S, Orso F, Fabbri G, De Bernardi A, Cirrincione V, Gonzini L et al. Agedependent prognostic significance of atrial fibrillation on outpatients with chronic heart failure: data from the Italian Network on Congestive Heart Failure Registry. Cardiology. 2010;116 (2):79–88.
  37. Sturm HB, HaaijerRuskamp FM, Veeger NJ, Balje‑Volkers CP, Swedberg K, van Gilst WH. The relevance of comorbidities for heart failure treatment in primary care: a European survey. Eur J Heart Fail. 2006 Jan;8 (1):31–7.
  38. Swedberg K, Olsson LG, Charlesworth A, Cleland J, Hanrath P, Komajda M et al. Prognostic relevance of atrial fibrillation in patients with chronic heart failure on long‑term treatment with beta‑blockers: results from COMET. Eur Heart J. 2005 Jul;26 (13):1303–8.
  39. Hoppe UC, Casares JM, Eiskjaer H, Hagemann A, Cleland JG, Freemantle N, Erdmann E. Effect of cardiac resynchronization on the incidence of atrial fibrillation in patients with severe heart failure. Circulation. 2006 Jul 4;114 (1):18–25.
  40. Lip GY, Laroche C, Popescu MI, Rasmussen LH, Vitali‑Serdoz L, Dan GA et al. Heart failure in patients with atrial fibrillation in Europe: a report from the EURObservational Research Programme Pilot survey on Atrial Fibrillation. Eur J Heart Fail. 2015 Jun;17 (6):570–82.
  41. Zakeri R , Borlaug BA, McNulty SE, Mohammed SF, Lewis GD, Semigran MJ et al. Impact of atrial fibrillation on exercise capacity in heart failure with preserved ejection fraction: a RELAX trial ancillary study. Circ Heart Fail. 2014 Jan;7 (1):123–30.
  42. Kakkar AK, Mueller I, Bassand JP, Fitzmaurice DA, Goldhaber SZ, Goto S et al. Risk profiles and antithrombotic treatment of patients newly diagnosed with atrial fibrillation at risk of stroke: perspectives from the international, observational, prospective GARFIELD registry. PLoS One. 2013 May 21;8 (5):e63479.
  43. Hsu JC, Maddox TM, Kennedy K, Katz DF, Marzec LN, Lubitz SA et al. Aspirin instead of oral anticoagulant prescription in atrial fibrillation patients at risk for stroke. J Am Coll Cardiol. 2016 Jun 28;67 (25):2913–23.
  44. Nelson WW, Choi JC, Vanderpoel J, Damaraju CV, Wildgoose P, Fields LE, Schein JR. Impact of comorbidities and patient characteristics on international normalized ratio control over time in patients with nonvalvular atrial fibrillation. Am J Cardiol. 2013 Aug 15;112 (4):509–12.
  45. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016 Jul 14;37 (27):2129–200.
  46. Muntwyler J, Cohen‑Solal A, Freemantle N, Eastaugh J, Cleland JG, Follath F. Relation of sex, age and concomitant diseases to drug prescription for heart failure in primary care in Europe. Eur J Heart Fail. 2004 Aug;6 (5):663–8.
  47. Komajda M, Follath F, Swedberg K, Cleland J, Aguilar JC, Cohen‑Solal A et al. The EuroHeart Failure Survey programme – a survey on the quality of care among patients with heart failure in Europe. Part 2: treatment. Eur Heart J. 2003 Mar;24 (5):464–74.
  48. Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL et al. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow‑Up Investigation of Rhythm Management (AFFIRM) study. Circulation. 2004 Mar 30;109 (12):1509–13.
  49. Ionescu‑Ittu R , Abrahamowicz M, Jackevicius CA, Essebag V, Eisenberg MJ, Wynant W et al. Comparative effectiveness of rhythm control vs rate control drug treatment effect on mortality in patients with atrial fibrillation. Arch Intern Med. 2012 Jul 9;172 (13):997–1004.
  50. Li SJ, Sartipy U, Lund LH, Dahlstrom U, Adiels M, Petzold M, Fu M. Prognostic significance of resting heart rate and use of b‑blockers in atrial fibrillation and sinus rhythm in patients with heart failure and reduced ejection fraction: findings from the Swedish Heart Failure Registry. Circ Heart Fail. 2015 Sep;8 (5):871–9.
  51. Lip GY, Heinzel FR , Gaita F, Juanatey JR , Le Heuzey JY, Potpara T et al. European Heart Rhythm Association/Heart Failure Association joint consensus document on arrhythmias in heart failure, endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society. Eur J Heart Fail. 2015 Sep;17 (9):848–74.
  52. Rienstra M, Damman K, Mulder BA, Van Gelder IC, McMurray JJ, Van Veldhuisen DJ. Beta‑blockers and outcome in heart failure and atrial fibrillation. A meta‑analysis. JACC Heart Fail. 2013 Feb;1 (1):21–8.
  53. Kotecha D, Holmes J, Krum H, Altman DG, Manzano L, Cleland JG et al. Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual‑patient data meta‑analysis. Lancet. 2014 Dec 20;384 (9961):2235–43.
  54. Van Gelder IC, Groenveld HF, Crijns Hj, Tuininga YS, Tijssen JG, Alings AM et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010 Apr 15;362 (15):1363–73.
  55. Daoud EG, Weiss R , Bahu M, Knight BP, Bogun F, Goyal R et al. Effect of an irregular ventricular rhythm on cardiac output. Am J Cardiol. 1996 Dec 15;78 (12):1433–6.
  56. Whitbeck MG, Charnigo RJ, Khairy P, Ziada K, Bailey AL, Zegarra MM et al. Increased mortality among patients taking digoxin – analysis from the AFFIRM study. Eur Heart J. 2013 May;34 (20):1481–8.
  57. Køber L, Swedberg K, McMurray JJ, Pfeffer MA, Velazquez EJ, Diaz R et al. Previously known and newly diagnosed atrial fibrillation: a major risk indicator after a myocardial infarction complicated by heart failure or left ventricular dysfunction. Eur J Heart Fail. 2006 Oct;8 (6):591–8.
  58. Gheorghiade M, Fonarow GC, van Veldhuisen DJ, Cleland JG, Butler J, Epstein AE et al. Lack of evidence of increased mortality among patients with atrial fibrillation taking digoxin: findings from post hoc propensity‑matched analysis of the AFFIRM trial. Eur Heart J. 2013 May;34 (20):1489–97.
Tereshchenko S.N., Romanova N.V., Zhirov I.V., Osmolovskaya Yu.F., Golitsyn S.P. Russian Registry of Patients with Chronic Heart Failure and Atrial Fibrillation (RIF-CHF): Clinical and demographic characteristics of the sample upon inclusion into the Registry. Russian Heart Failure Journal. 2016;17 (6):418–426

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