Key result
Concomitant CHF in AF is linked to higher thromboembolic risk and more comorbidities.
Why the study?
Do baseline characteristics and thromboembolic risk differ between atrial fibrillation patients with and without congestive heart failure?
Observational (n=3,506)
Yes
Do baseline characteristics and thromboembolic risk differ between atrial fibrillation patients with and without congestive heart failure?
Absolute Event Rate: 3.8% vs 2.6%
p-value: p=<0.001
Atrial fibrillation patients with concomitant congestive heart failure have a significantly higher burden of comorbidities and higher thromboembolic risk compared to those without heart failure.
Congestive heart failure (CHF) and atrial fibrillation (AF) frequently coexist and are associated with increased risk of cardiovascular events.To compare baseline characteristics, comorbidities and pharmacotherapy in AF patients with concomitant CHF to those without CHF.The study included 3506 real-life AF patients with (37.1%) and without CHF - participants of the multicentre, retrospective MultiCenter expeRience in AFib patients Treated with OAC (CRAFT) trial (NCT02987062).All patients were treated with non-vitamin K antagonist oral anticoagulants (NOAC) or vitamin K antagonists (VKA). The frequency of NOAC among patients with and without CHF was 45.6% and 43.2%, respectively (P = .17). Patients with CHF were older (73.3 vs 64.7 years, P <.001), less likely to be women (37.4% vs 42%, P = .007), had higher CHA2DS2-VASc score (3.8 ± 1.7 vs 2.6 ± 1.8, P <.001), more often had permanent AF (53.0% vs 13.4%, P <.001), chronic obstructive pulmonary disease (16.7% vs 4.9%, P <.001), coronary artery disease (64.3% vs 29.8%, P <.001), peripheral vascular disease (65.3% vs 31.4%, P <.001), chronic kidney disease (43.1% vs 10.0%, P <.001), liver fibrosis (5.7% vs 2.6%, P <.001), neoplasm (9.6% vs 7.3%, P = .05), history of composite of stroke, transient ischemic attack or systemic embolization (16.2% vs 10.7%, P <.001), pacemaker (27.4% vs 22.1%, P = .004), implantable cardioverter-defibrillator (22.7% vs 0.8%, P <.001) or transaortic valve implantation (4.0% vs 0.8%, P <.001), cardiac resynchronization therapy (8.7% vs 0.3%, P <.001), composite of kidney transplantation, hemodialysis or creatinine level > 2.26 mg/dL (3.6% vs 0.8%, P <.001) and had less often hypertension (69.4% vs 72.5%, P = .05).Patients with AF and CHF had a higher thromboembolic risk and had more concomitant diseases.
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Balsam et al. (2018) conducted an observational in Atrial fibrillation with and without congestive heart failure (n=3,506). Congestive heart failure (CHF) vs. Without congestive heart failure was evaluated on CHA2DS2-VASc score (p=<0.001). Atrial fibrillation patients with concomitant congestive heart failure had a significantly higher thromboembolic risk (CHA2DS2-VASc score 3.8 vs 2.6) and more comorbidities compared to those without heart failure.
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