{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T02:20:26Z","timestamp":1786760426145,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Atrial fibrillation (AF) and heart failure (HF) often coexist. However, whether AF onset before HF or vice versa is associated with the worst outcome remains unclear. A consensus of large studies can guide future research and preventive strategies to better target high-risk patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We included all Danish cases with the coexistence of AF and HF (2005\u201317) using nationwide registries. Patients were divided into three separate groups (i) AF before HF, (ii) HF before AF, or (iii) AF and HF diagnosed concurrently (\u00b130 days). Adjusting landmark Cox analyses (index date was the time of the latter diagnosis of AF or HF) were used for evaluating the association of the three groups with a composite outcome of ischaemic stroke or death. Among a total of 49 042 patients included, 40% had AF before HF, 27% had HF before AF, and 33% had AF and HF diagnosed concurrently. The composite endpoint accrued more often in patients with HF before AF compared to the two other groups (&amp;lt;0.001), and this remained significant in the adjusted analyses with hazard ratios (95% confidence intervals) of 1.26 (1.22\u20131.30) compared to AF before HF. Finally, antihypertensive treatment, oral anticoagulants, amiodarone, statins, and AF ablation were associated with a lower hazard ratio of the composite endpoint (all &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large Danish national cohort, diagnosis of HF before AF was associated with an increased absolute risk of death compared to AF before HF and AF and HF diagnosed concurrently. Antihypertensive treatment, oral anticoagulants, amiodarone, statins, and AF ablation may improve prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1093\/europace\/euac186","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T08:48:49Z","timestamp":1667983729000},"page":"283-290","source":"Crossref","is-referenced-by-count":22,"title":["Atrial fibrillation onset before heart failure or vice versa: what is worst? A nationwide register study"],"prefix":"10.1093","volume":"25","author":[{"given":"Jannik","family":"Pallisgaard","sequence":"first","affiliation":[{"name":"Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University , Copenhagen 2900 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders M","family":"Greve","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University , Copenhagen 2100 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Lock-Hansen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University , Copenhagen 2900 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3621-3775","authenticated-orcid":false,"given":"Jens Jakob","family":"Thune","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen University , Copenhagen 2400 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2048-4167","authenticated-orcid":false,"given":"Emil Loldrup","family":"Fosboel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University , Copenhagen 2100 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8542-4982","authenticated-orcid":false,"given":"Richard B","family":"Devereux","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Weill Cornell Medical College , New York, NY 10065 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M","family":"Okin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Weill Cornell Medical College , New York, NY 10065 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0548-402X","authenticated-orcid":false,"given":"Gunnar H","family":"Gislason","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University , Copenhagen 2900 , Denmark"},{"name":"Department of Research, Danish Heart Foundation , Copenhagen 1120 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-6131","authenticated-orcid":false,"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, North Zealand Hospital, Copenhagen University , Copenhagen 3400 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4618-6096","authenticated-orcid":false,"given":"Casper N","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, 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