What is the clinical evidence from this study?

Study design: Cohort. Population: Symptomatic peripheral artery disease (n=1585). Intervention: Atrial fibrillation vs. No atrial fibrillation. Primary outcome: Heart failure-related events (HR 4.03, 95% CI 1.85-8.78, p=<0.001).

What does this research mean for the field?

In patients with peripheral artery disease undergoing endovascular therapy, atrial fibrillation significantly increases the risk of subsequent heart failure-related events, with this prognostic impact being markedly stronger in patients without pre-existing heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the prognostic impact of atrial fibrillation on heart failure-related events following endovascular therapy for peripheral artery disease, stratified by baseline heart failure status.

August 22, 2026Heart and Vessels

AF linked to ~303% higher risk of incident HF events in PAD patients undergoing EVT.

Q: What are the key findings of this study?

Atrial fibrillation was strongly associated with heart failure-related events in PAD patients undergoing endovascular therapy without baseline heart failure (HR 4.03; 95% CI 1.85-8.78; p<0.001).

Q: What does this research mean for the field?

In patients with peripheral artery disease undergoing endovascular therapy, atrial fibrillation significantly increases the risk of subsequent heart failure-related events, with this prognostic impact being markedly stronger in patients without pre-existing heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the prognostic impact of atrial fibrillation on heart failure-related events following endovascular therapy for peripheral artery disease, stratified by baseline heart failure status.

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Why the study?

The impact of atrial fibrillation on heart failure-related events after endovascular therapy for peripheral artery disease remained unclear, particularly according to baseline heart failure status.

Does atrial fibrillation increase the risk of heart failure-related events in patients with symptomatic peripheral artery disease undergoing endovascular therapy?

Population

1585 patients with symptomatic PAD undergoing EVT

Comparison

Patients with AF vs without AF, stratified by baseline HF status

Design

Retrospective multicenter cohort study

Follow-up

3-year follow-up period

Key result

Atrial fibrillation was strongly associated with heart failure-related events in PAD patients undergoing endovascular therapy without baseline heart failure (HR 4.03; 95% CI 1.85-8.78; p<0.001).

Authors

YSYuki Shima EKEiji Karashima SKShingo Kurimoto

Discussion

Member takes

Overview

AF may elevate post-EVT HF events in PAD; leaves open modification by baseline HF status.

Key Points

To evaluate the prognostic impact of atrial fibrillation on heart failure-related events following endovascular therapy for peripheral artery disease, stratified by baseline heart failure status.
Retrospective multicenter cohort study analyzing 1585 patients with symptomatic peripheral artery disease undergoing endovascular therapy.
Patients were stratified by baseline atrial fibrillation and heart failure status, with outcomes tracked over a 3-year follow-up using Kaplan-Meier analysis and multivariable Cox proportional hazards models.
In patients without baseline heart failure, atrial fibrillation significantly reduced 3-year event-free survival (87.9% vs. 96.8%, log-rank p < 0.001) and markedly increased heart failure-related event risk (HR 4.03, 95% CI 1.85–8.78; p < 0.001).
In patients with established heart failure, the association between atrial fibrillation and heart failure events was attenuated (3-year survival 67.2% vs. 75.7%, log-rank p = 0.053; HR 1.34, 95% CI 0.96–1.88; p = 0.085; p for interaction = 0.013).

Study Design

Type

Cohort (n=1,585)

Multicenter

Yes

Structured PICO

Does atrial fibrillation increase the risk of heart failure-related events in patients with symptomatic peripheral artery disease undergoing endovascular therapy?

Population

1,585 patients with symptomatic peripheral artery disease undergoing endovascular therapy, followed for 3 years.

Exposure

Atrial fibrillation (AF)

Comparator

No atrial fibrillation

Outcome

Heart failure (HF)-related events over a 3-year follow-up periodhard clinical

Main Result

Hazard Ratio: 4.03 (95% CI 1.85–8.78)

Absolute Event Rate: 87.9% vs 96.8%

p-value: p=<0.001

Atrial fibrillation is a strong predictor of incident heart failure events in patients with peripheral artery disease undergoing endovascular therapy, especially in those without a prior history of heart failure.

Cite This Study

Shima et al. (2026) conducted a cohort in Symptomatic peripheral artery disease (n=1,585). Atrial fibrillation vs. No atrial fibrillation was evaluated on Heart failure-related events (HR 4.03, 95% CI 1.85-8.78, p=<0.001). Atrial fibrillation was strongly associated with heart failure-related events in PAD patients undergoing endovascular therapy without baseline heart failure (HR 4.03; 95% CI 1.85-8.78; p<0.001).

synapsesocial.com/papers/6a898345ca7ade938187f3ec https://doi.org/10.1007/s00380-026-02749-1

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August 22, 2026Heart and Vessels

AF linked to ~303% higher risk of incident HF events in PAD patients undergoing EVT.

View Full Paper

Ask AI

Bookmark

Why the study?

The impact of atrial fibrillation on heart failure-related events after endovascular therapy for peripheral artery disease remained unclear, particularly according to baseline heart failure status.

Does atrial fibrillation increase the risk of heart failure-related events in patients with symptomatic peripheral artery disease undergoing endovascular therapy?

Population

1585 patients with symptomatic PAD undergoing EVT

Comparison

Patients with AF vs without AF, stratified by baseline HF status

Design

Retrospective multicenter cohort study

Follow-up

3-year follow-up period

Key result

Atrial fibrillation was strongly associated with heart failure-related events in PAD patients undergoing endovascular therapy without baseline heart failure (HR 4.03; 95% CI 1.85-8.78; p<0.001).

Authors

YSYuki Shima EKEiji Karashima SKShingo Kurimoto

Discussion

Member takes

Overview

AF may elevate post-EVT HF events in PAD; leaves open modification by baseline HF status.

Key Points

To evaluate the prognostic impact of atrial fibrillation on heart failure-related events following endovascular therapy for peripheral artery disease, stratified by baseline heart failure status.
Retrospective multicenter cohort study analyzing 1585 patients with symptomatic peripheral artery disease undergoing endovascular therapy.
Patients were stratified by baseline atrial fibrillation and heart failure status, with outcomes tracked over a 3-year follow-up using Kaplan-Meier analysis and multivariable Cox proportional hazards models.
In patients without baseline heart failure, atrial fibrillation significantly reduced 3-year event-free survival (87.9% vs. 96.8%, log-rank p < 0.001) and markedly increased heart failure-related event risk (HR 4.03, 95% CI 1.85–8.78; p < 0.001).
In patients with established heart failure, the association between atrial fibrillation and heart failure events was attenuated (3-year survival 67.2% vs. 75.7%, log-rank p = 0.053; HR 1.34, 95% CI 0.96–1.88; p = 0.085; p for interaction = 0.013).

Study Design

Type

Cohort (n=1,585)

Multicenter

Yes

Structured PICO

Does atrial fibrillation increase the risk of heart failure-related events in patients with symptomatic peripheral artery disease undergoing endovascular therapy?

Population

1,585 patients with symptomatic peripheral artery disease undergoing endovascular therapy, followed for 3 years.

Exposure

Atrial fibrillation (AF)

Comparator

No atrial fibrillation

Outcome

Heart failure (HF)-related events over a 3-year follow-up periodhard clinical

Main Result

Hazard Ratio: 4.03 (95% CI 1.85–8.78)

Absolute Event Rate: 87.9% vs 96.8%

p-value: p=<0.001

Cite This Study

synapsesocial.com/papers/6a898345ca7ade938187f3ec https://doi.org/10.1007/s00380-026-02749-1

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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