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September 18, 2018European Heart JournalOpen Access

Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: a report from 14 964 patients in the European Society of Cardiology Heart Failure Long-Term Registry

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Why the study?

Does atrial fibrillation worsen cardiovascular outcomes compared to sinus rhythm in patients with different ejection fraction subtypes of heart failure?

Population

14,964 patients with acute and chronic heart failure, mean age 66 ± 13 years, 67% male, from the European…

Comparison

Atrial fibrillation (AF) vs Sinus rhythm (SR)

Design

Cohort

Follow-up

up to ~2.2 years

Key result

Atrial fibrillation was associated with increased risk of all-cause death or HF hospitalization in patients with HFpEF (HR 1.365; 95% CI 1.152-1.619) and HFmrEF, but not HFrEF.

Authors

BZBarak ZafrirLLLars H. LundCLCécile Laroche

Discussion

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Overview

May warrant closer monitoring in HFpEF/HFmrEF; leaves open whether rhythm control modifies outcomes.

Study Design

Type

Observational (n=14,964)

Multicenter

Yes

Structured PICO

Does atrial fibrillation worsen cardiovascular outcomes compared to sinus rhythm in patients with different ejection fraction subtypes of heart failure?

P
Population
14,964 patients with acute and chronic heart failure across the ejection fraction spectrum (mean age 66, 33% female), followed for up to ~2.2 years.
E
Exposure
Atrial fibrillation (AF)
C
Comparator
Sinus rhythm (SR)
O
Outcome
Combined all-cause death or HF hospitalizationscomposite

Main Result

Hazard Ratio: 1.365 (95% CI 1.152–1.619)

p-value: p=<0.001

Atrial fibrillation is associated with worse cardiovascular outcomes in patients with HFpEF and HFmrEF, but not in those with HFrEF.

Cite This Study

Zafrir et al. (2018) conducted an observational in Heart failure (n=14,964). Atrial fibrillation vs. Sinus rhythm was evaluated on Combined all-cause death or HF hospitalizations in HFpEF (HR 1.365, 95% CI 1.152-1.619, p=<0.001). Atrial fibrillation was associated with increased risk of all-cause death or HF hospitalization in patients with HFpEF (HR 1.365; 95% CI 1.152-1.619) and HFmrEF, but not HFrEF.

synapsesocial.com/papers/6a81b8fa52af26425e4d58dchttps://doi.org/10.1093/eurheartj/ehy626
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