Heart failure & cardiomyopathies
Atrial Fibrillation Development in the Heart Failure Population from Nationwide British Linked Electronic Health Records
Authors' conclusion
Incident AF in the HF population is high, with good genetic correlation for the two conditions. Identified predictors for new-onset AF might be helpful to improve management of HF patients and AF prevention.
Study context
- Population
- Participants with a diagnosis of heart failure (HF) (January 1998 to May 2016) and no previous history of atrial fibrillation (AF)no previous history of AF, of 163,174 participants with a diagnosis of HF
- Participants
- 111,595 participants
- Exposure
- Factors associated with new-onset AF in patients with HF
- Outcome
- Incidence rate for AF
- Follow-up
- Median 1.33 years, IQR 0.15-4.18
Methodological detailsClinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES), multivariate weighted Cox regression, linkage disequilibrium score regression
- Clinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES)
- Multivariate weighted Cox regression
- Linkage disequilibrium score regression
Main finding
As reported in the abstract
30 days
2.8%
1 year
9.9%
3 years
18.0%
5 years
24.9%
Observational data: associations, not effects.
Further findings
Predictors of new-onset AF
| HR (95% CI) | ||
|---|---|---|
| Female sexMultivariate weighted Cox regression | 0.79 (0.71–0.88) | |
| AgeMultivariate weighted Cox regression | 1.04 (1.04–1.04) | |
| White ethnicityMultivariate weighted Cox regression | 1.30 (1.06–1.59) | |
| Social deprivationMultivariate weighted Cox regression | 1.20 (1.01–1.42) | |
| BMIMultivariate weighted Cox regression | 1.01 (1.00–1.02) | |
| Gentle physical activityMultivariate weighted Cox regression | 0.84 (0.72–0.97) | |
| HypertensionMultivariate weighted Cox regression | 1.15 (1.03–1.29) | |
| Chronic kidney diseaseMultivariate weighted Cox regression | 1.15 (1.06–1.24) | |
| Chronic obstructive pulmonary disease (COPD)Multivariate weighted Cox regression | 1.10 (1.01–1.19) | |
| Valvular heart diseaseMultivariate weighted Cox regression | 1.17 (1.06–1.29) | |
| Angiotensin-converting enzyme inhibitorsMultivariate weighted Cox regression | 0.88 (0.80–0.96) | |
| 0.512Hazard ratio (log scale) |
- Predictors of new-onset AF: associated with lower AF incidence; magnitude dependent on duration of administration
Genetic correlation (linkage disequilibrium score regression)
- AF and HF rg
- 0.57, P = 2.30 × 10-59
- AF and BMI rg
- 0.19, P = 6.18 × 10-20
- Systolic and diastolic blood pressure, smoking, and chronic obstructive pulmonary disease (COPD)
- P values ranging from <10-4 to <0.05
Original publication
Atrial Fibrillation Development in the Heart Failure Population from Nationwide British Linked Electronic Health Records. ESC Heart Fail. Published 12 March 2025. doi:10.
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