Heart failure & cardiomyopathiesMeta-analysis
Heart rate and atrial fibrillation/flutter in HFmrEF/HFpEF: a participant-level analysis across five randomized clinical trials
- Pooled participant-level analysis of five randomised clinical trials
- multivariable Cox and Poisson regression
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
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