Key Points
- To determine the prevalence, clinical characteristics, and long-term prognostic impact of atrial fibrillation in unselected outpatients with heart failure.
- Followed 2,024 symptomatic heart failure outpatients evaluated at the Cardiovascular Institute Hospital from the Shinken Database cohort (2004–2011, N=17,517).
- Compared baseline features and analyzed clinical outcomes using Kaplan–Meier survival curves and multivariable adjusted Cox proportional hazards regression models.
- Atrial fibrillation occurred in 310 patients (15%) who were older, more often female, had higher NYHA class III/IV rates, lower ejection fraction, and higher cardiovascular drug usage.
- Unadjusted analyses showed higher risks of all-cause mortality, cardiovascular death, and heart failure admission in patients with atrial fibrillation, but associations with mortality were non-significant after multivariable adjustment.
- Atrial fibrillation remained an independent predictor of heart failure-related hospital admission in the adjusted Cox regression model (hazard ratio, 1.781; 95% confidence interval, 1.172–2.704; p=0.007).
Structured PICO
Does atrial fibrillation increase the risk of mortality and HF-related admission in outpatients with heart failure?
PPopulation2024 symptomatic outpatients with heart failure (from The Shinken Database: 2004–2011)
IInterventionPresence of atrial fibrillation (AF)
CComparatorAbsence of atrial fibrillation
OOutcomeAll-cause death, cardiovascular death, and HF-related admissionhard clinical
In outpatients with heart failure, atrial fibrillation is independently associated with an increased risk of HF-related hospitalization, but not long-term mortality.