Heart failure & cardiomyopathies
The impact of atrial fibrillation on clinical outcomes in heart failure with mid-range and preserved ejection fraction patients
Authors' conclusion
Compared with SR, AF was independently associated with worse outcomes across all LVEF ranges.
Study context
- Population
- Heart failure (HF) patients stratified by left ventricular ejection fraction (LVEF): HFmrEF (LVEF 45%-50%, n = 823), HF with preserved ejection fraction (HFpEF) (LVEF 51%-60%, n = 1682), HF with normal ejection fraction (HFnEF) (LVEF >60%, n = 937)
- Participants
- 3,442 patients
- Comparison
- Atrial fibrillation (AF) vs sinus rhythm, by LVEF range
- Primary endpoint
- Primary outcome (as defined in TOPCAT), by LVEF subgroup
Methodological detailspost hoc analysis, Cox regression analysis
- Post hoc analysis
- Cox regression analysis
Primary result
As reported in the abstract
Primary outcome, AF vs SR, by LVEF subgroup
AF vs SRHazard ratio (CI)P value
HFmrEF
1.11(1.01–1.22)
P = 0.03HFpEF
1.20(1.11–1.29)
P < 0.001HFnEF
1.16(1.05–1.28)
P = 0.004Further findings
AF prevalence by LVEF subgroup
- AF prevalence by LVEF subgroup: P = .07
HF hospitalisation and CV mortality
- AF associated with HF hospitalizations and worse CV mortality in HFpEF and HFnEF
LVEF as continuous variable
- Linear negative association between LVEF and effect of AF vs sinus rhythm (SR) for primary end point and HF hospitalizations; linear positive association for CV mortality
Original publication
The impact of atrial fibrillation on clinical outcomes in heart failure with mid-range and preserved ejection fraction patients. Heart Rhythm. Published 24 May 2024. doi:10.
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