Heart failure & cardiomyopathies

Heart rate and atrial fibrillation/flutter in HFmrEF/HFpEF: a participant-level analysis across five randomized clinical trials

Eur J Heart FailPublished Pooled participant-level analysis of five randomised clinical trials

Pooled result · CV death or HF hospitalization by baseline heart rate and AFF statusResult — go to the resultAdj HR 1.19 CI 1.10–1.27

Authors' conclusion

In this analysis of five HFmrEF/HFpEF trials, baseline heart rate was associated with significantly higher rates of events only in patients in sinus rhythm but not in those with AFF.

Study context

Population
Patients with HFmrEF/HFpEF in CHARM-Preserved, I-PRESERVE, TOPCAT-Americas, PARAGON-HF and DELIVER
Participants
19,975 patients · 5 RCTs
Comparison
AFF vs sinus rhythm on baseline ECG, by baseline heart rate
  • AFFn = 5,816
Outcome
CV death or HF hospitalization
Methodological detailsmultivariable Cox and Poisson regression
  • Multivariable Cox and Poisson regression

Pooled result

As reported in the abstract

CV death or HF hospitalization by baseline heart rate and AFF status

Adj HR

1.19

CI 1.10–1.27

AFF vs Sinus rhythm
adj HR 1.19 (CI 1.10–1.27)
Sinus rhythm: higher event rates with increasing heart rate; AFF: similar rates across baseline heart rate
P for interaction < 0.001

Further pooled results

Baseline heart rate

P < 0.001

Original publication

Heart rate and atrial fibrillation/flutter in HFmrEF/HFpEF: a participant-level analysis across five randomized clinical trials. Eur J Heart Fail. Published 29 January 2026. doi:10.1093/ejhf/xuag029

Summarised from the published abstract; every number is checked against it

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