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- Date2021-02-23 17:10
- Update2021-02-23 17:10
- CountersignatureDivision of Research Planning
Heart, 2020.106(15), 1160-1168, DOI: https://doi.org/10.1136/heartjnl-2019-316219
Impact of atrial fibrillation in patients with heart failure and reduced, mid-range or preserved ejection fraction
Mi Kyoung Son, Nam-Kyoo Lim; Won-Ho Kim; Dong-Ju Choi
Objective: To determine the prognostic value of atrial fibrillation (AF) in patients with heart failure (HF) and preserved, mid-range, or reduced ejection fraction (EF).
Methods: Patients hospitalized for acute HF were enrolled in the Korean Acute Heart Failure (KorAHF) registry, a prospective observational multicenter cohort study, between March 2011 and February 2014. HF types were defined as reduced EF (HFrEF, LVEF <40%), mid-range EF (HFmrEF, LVEF 40–49%), or preserved EF (HFpEF, LVEF ≥50%).
Results: Of 5,414 patients enrolled, HFrEF, HFmrEF, and HFpEF was seen in 3,182 (58.8%), 875 (16.2%), and 1,357 (25.1%) patients, respectively. The prevalence of AF significantly increased with increasing EF (HFrEF 28.9%, HFmrEF 39.8%, HFpEF 45.2%; P for trend <0.001). During follow-up (median, 4.03 years; IQR, 1.39–5.58 years), 2,806 (51.8%) patients died. The adjusted hazard ratio (HR) of AF for all-cause death was 1.06 (0.93–1.21) in the HFrEF; 1.10 (0.87–1.39) in the HFmrEF; and 1.22 (1.02–1.46) in the HFpEF groups; the HR for the composite of all-cause death or readmission was 0.97 (0.87–1.07), 1.14 (0.93–1.38), and 1.03 (0.88–1.19) in the HFrEF, HFmrEF, and HFpEF groups, respectively; the HR for stroke was 1.53 (1.03–2.29), 1.04 (0.57–1.91), and 1.90 (1.13–3.20), respectively. Similar results were observed after propensity score matching analysis.
Conclusions: AF was more common with increasing EF. AF was seen to be associated with increased mortality only in patients with HFpEF and was associated with an increased risk of stroke in patients with HFrEF or HFpEF.
- DOI: https://doi.org/10.1136/heartjnl-2019-316219
- ISBN or ISSN: 1355-6037
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.