Heart failure & cardiomyopathies
Combination of heart failure and atrial fibrillation worsens ethnicity-related disparity: an individual patient-level meta-analysis of randomized trials
Pooled result · All-cause mortalityResult — go to the resultHazard ratio 1.36 95% CI 1.20–1.54Authors' conclusion
Non-white patients with HF and reduced ejection fraction suffer from substantially higher rates of death than white patients, with comorbid atrial fibrillation leading to significant worsening of this ethnicity-related disparity.
Study context
- Population
- Patients with heart failure (HF) (reduced EF) in 12 placebo-controlled RCTs (11 vs beta-blockers, 1 vs spironolactone); 3145 with comorbid atrial fibrillation (AF), 13,568 in sinus rhythm
- Participants
- 16,713 patients · 12 RCTs
- Comparison
- Non-white vs white ethnicity
- Non-whiten = 1,899
- Outcome
- All-cause mortality
- Follow-up
- Median 1.4 years
Methodological detailsplacebo-controlled trials, confounder-adjusted, propensity-score matching
- Placebo-controlled trials
- Confounder-adjusted
- Propensity-score matching
Pooled result
All-cause mortality
Hazard ratio
1.36
95% CI 1.20–1.54
P < 0.001
Events by group
Non-white vs White
HR 1.36 (95% CI 1.20–1.54); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality, by rhythm (HF+AF vs HF in sinus rhythm) — Non-white vs White · HF with coexisting AF | 2.05 (1.55–2.70) | P < 0.001 | |
| All-cause mortality, by rhythm (HF+AF vs HF in sinus rhythm) — Non-white vs White · HF in sinus rhythm | 1.24 (1.08–1.41) | P = 0.002 | |
| 0.20.5125Hazard ratio (log scale) |
- All-cause mortality, by rhythm (HF+AF vs HF in sinus rhythm): interaction P=.003
- All-cause mortality, by rhythm (HF+AF vs HF in sinus rhythm): confirmed with propensity-score matching (P = .009)
CV and HF-related death; CV and HF-related hospitalization
- Similar disparities with ethnicity
Original publication
Combination of heart failure and atrial fibrillation worsens ethnicity-related disparity: an individual patient-level meta-analysis of randomized trials. Eur J Heart Fail. Published 24 February 2026. doi:10.
Summarised from the published abstract; every number is checked against it