Arrhythmias & electrophysiology
Both heart failure with preserved ejection fraction (HFpEF) and heart failure with mid-range ejection fraction (HFmrEF) should be included in calculating CHA2DS2-VASc score: A Taiwanese longitudinal cohort
Authors' conclusion
After multivariate adjustment, HFpEF and HFmrEF showed a similar risk of stroke in AF patients.
Study context
- Population
- Patients with Atrial Fibrillation (AF), National Taiwan University Hospital integrated Medical Database
- Participants
- 8,358 patients
- Exposure
- HFpEF, HFmrEF and Heart Failure with Reduced Ejection Fraction (HFrEF) vs no Congestive Heart Failure (CHF)
- Outcome
- Ischemic stroke
- Follow-up
- Mean 3.76 years
Methodological detailslongitudinal, single hospital database, multivariate-adjusted Cox models
- Longitudinal
- Single hospital database
- Multivariate-adjusted Cox models
Main finding
As reported in the abstract
Ischemic stroke (multivariate-adjusted)
Each group vs no CHFHazard ratio (CI)P value
HFmrEF
1.40(1.161–1.688)
P < 0.001HFpEF
1.184(1.075–1.303)
P = 0.001Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| Ischemic stroke, CHA2DS2-VASc 0-4 (subgroup)HFrEFvs No CHF | 1.568 (1.189–2.068) | P = 0.001 | |
| Ischemic stroke, CHA2DS2-VASc 0-4 (subgroup)HFmrEFvs No CHF | 1.890 (1.372–2.603) | P < 0.001 | |
| Ischemic stroke, CHA2DS2-VASc 0-4 (subgroup)HFpEFvs No CHF | 1.800 (1.526–2.123) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Mean
| Outcome | HFpEF | HFmrEF | HFrEF |
|---|---|---|---|
| Mean CHA2DS2-VASc score | 4.30 (SD 1.729) | 4.15 (SD 1.736) | 3.73 (SD 1.712) |
- Mean CHA2DS2-VASc score: P < .001
Original publication
Both HFpEF and HFmrEF should be included in calculating CHA2DS2-VASc score: A Taiwanese longitudinal cohort. Heart Rhythm. Published 27 February 2024. doi:10.
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