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February 13, 2024Journal of Cardiovascular ElectrophysiologyOpen Access

AF linked to ~25% higher mortality and more HF hospitalizations in HFmrEF versus HFrEF.

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Why the study?

Heart failure and atrial fibrillation frequently coexist, but aggregate data comparing the risk profile of atrial fibrillation across HFrEF, HFmrEF, and HFpEF are lacking.

Does the presence of atrial fibrillation increase the risk of adverse outcomes in patients with HFrEF, HFmrEF, and HFpEF?

Population

248 323 patients across 22 studies with HFrEF, HFmrEF, and HFpEF

Comparison

AF vs no AF across HFrEF, HFmrEF, and HFpEF categories

Design

Systematic review and meta-analysis

Key result

Atrial fibrillation was associated with a higher risk of all-cause mortality (HR 1.25) and HF hospitalizations (HR 1.64) in patients with HFmrEF compared to HFrEF.

Authors

GKGaren KroshianJJJacob JosephSKScott Kinlay

Discussion

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Member takes

Overview

Supports AF vigilance in HFmrEF; extends evidence on stronger prognostic links than in HFrEF.

Structured PICO

Does the presence of atrial fibrillation increase the risk of adverse outcomes in patients with HFrEF, HFmrEF, and HFpEF?

P
Population
248,323 patients with heart failure from 22 studies, including HFrEF (n=123,331, 49.7%), HFmrEF (n=40,995, 16.5%), and HFpEF (n=83,997, 33.8%).
I
Intervention
Presence of atrial fibrillation
C
Comparator
Absence of atrial fibrillation
O
Outcome
All-cause mortality, heart failure hospitalizations, cardiovascular mortality, and strokehard clinical

Atrial fibrillation is associated with increased all-cause mortality and heart failure hospitalizations in patients with HFmrEF and HFpEF, but not in those with HFrEF.

Cite This Study

Kroshian et al. (2024) studied this question. Atrial fibrillation was associated with a higher risk of all-cause mortality (HR 1.25) and HF hospitalizations (HR 1.64) in patients with HFmrEF compared to HFrEF.

synapsesocial.com/papers/696688f2314faaf32ec7a4cfhttps://doi.org/10.1111/jce.16209
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