Heart failure & cardiomyopathiesCohort study
Clinical impact of atrial fibrillation progression in patients with heart failure with preserved ejection fraction: A report from the CHART-2 Study
- Prospective cohort study (CHART-2 registry analysis)
- multivariable Cox proportional hazards model
Authors' conclusion
In patients with HFpEF, AF progression is significantly associated with adverse outcomes, particularly worsening heart failure.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) and paroxysmal atrial fibrillation (AF) in the CHART-2 Study (Tohoku District, Japan)median age 72 y, 36% female
- Participants
- 718 patients
- Exposure
- AF progression vs no AF progression
- Outcome
- Incidence of AF progression (transition from paroxysmal to persistent AF) and its clinical impact
- Follow-up
- Median 6.0 years
Main finding
As reported in the abstract
AF progression · median follow-up 6.0 years (IQR 3.0-10.2)
AF progression occurred (n = 105)
14.6%
Cumulative incidence of AF progression at 10 years
16.7%
Observational data: associations, not effects.
Further findings
Predictors of AF progression (multivariable Cox model)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| previous hospitalization for heart failure | 1.74 (1.16–2.60) | P = 0.007 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Predictors of AF progression (multivariable Cox model) — left atrial diameter (per 5-mm increase) | 1.37 (1.20–1.55) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Worsening HF associated with AF progression
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| AF progression | 1.68 (1.18–2.40) | P = 0.004 | |
| 0.512Adjusted hazard ratio (log scale) |
- Worsening HF associated with AF progression — Worsening HF within 1 year following AF progression
- 27 cases (26%)
Original publication
Clinical impact of atrial fibrillation progression in patients with heart failure with preserved ejection fraction: A report from the CHART-2 Study. Europace. Published 16 August 2024. doi:10.1093/europace/euae218
Summarised from the published abstract; every number is checked against it