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Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction
AIMS: Atrial fibrillation (AF) is a common comorbid condition in heart failure with preserved ejection fraction (HFpEF). The effect of AF on heart failure (HF) exacerbation in HFpEF has not been well described. This study investigated how AF modifies the clinical trajectory of HFpEF patients after h...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715808/ https://www.ncbi.nlm.nih.gov/pubmed/35712815 http://dx.doi.org/10.1002/ehf2.13836 |
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author | Yang, Eunice Vaishnav, Joban Song, Evelyn Lee, Joan Schulman, Steven Calkins, Hugh Berger, Ronald Russell, Stuart D. Sharma, Kavita |
author_facet | Yang, Eunice Vaishnav, Joban Song, Evelyn Lee, Joan Schulman, Steven Calkins, Hugh Berger, Ronald Russell, Stuart D. Sharma, Kavita |
author_sort | Yang, Eunice |
collection | PubMed |
description | AIMS: Atrial fibrillation (AF) is a common comorbid condition in heart failure with preserved ejection fraction (HFpEF). The effect of AF on heart failure (HF) exacerbation in HFpEF has not been well described. This study investigated how AF modifies the clinical trajectory of HFpEF patients after hospitalization for decompensated HF. METHODS AND RESULTS: We stratified HFpEF subjects by AF diagnosis and performed longitudinal analysis to compare risk for HF hospitalization after index hospitalization for decompensated HF. All‐cause mortality, 30 day all‐cause readmissions, and response to inpatient diuresis were also evaluated. Of 90 subjects enrolled, 35.6% (n = 32) had AF. Subjects with AF were older (72.5 vs. 60.5 years; P < 0.01), more often male (46.9% vs. 24.1%; P = 0.03), and had greater left atrial diameter (4.9 vs. 3.8 cm; P < 0.01) compared with those without AF. Subjects with AF had a higher risk for HF hospitalization than their counterparts without AF (P = 0.02); this relationship remained significant following multivariable competing risk regression with propensity score weighting (hazard ratio 2.53, P = 0.04 and hazard ratio 2.91, P = 0.04, with overlap and inverse probability weighting, respectively). Although having AF appeared to increase the risk of all‐cause hospital readmission within 30 days of discharge (37.5% vs. 17.5%; P = 0.036), this relationship failed to remain significant following propensity score adjustment for clinical covariates. CONCLUSIONS: Atrial fibrillation is an independent risk factor for HF rehospitalization in HFpEF. Further understanding of the interplay between AF and HFpEF will be critical to guide the selection of appropriate rhythm management strategies in this population. |
format | Online Article Text |
id | pubmed-9715808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97158082022-12-05 Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction Yang, Eunice Vaishnav, Joban Song, Evelyn Lee, Joan Schulman, Steven Calkins, Hugh Berger, Ronald Russell, Stuart D. Sharma, Kavita ESC Heart Fail Original Articles AIMS: Atrial fibrillation (AF) is a common comorbid condition in heart failure with preserved ejection fraction (HFpEF). The effect of AF on heart failure (HF) exacerbation in HFpEF has not been well described. This study investigated how AF modifies the clinical trajectory of HFpEF patients after hospitalization for decompensated HF. METHODS AND RESULTS: We stratified HFpEF subjects by AF diagnosis and performed longitudinal analysis to compare risk for HF hospitalization after index hospitalization for decompensated HF. All‐cause mortality, 30 day all‐cause readmissions, and response to inpatient diuresis were also evaluated. Of 90 subjects enrolled, 35.6% (n = 32) had AF. Subjects with AF were older (72.5 vs. 60.5 years; P < 0.01), more often male (46.9% vs. 24.1%; P = 0.03), and had greater left atrial diameter (4.9 vs. 3.8 cm; P < 0.01) compared with those without AF. Subjects with AF had a higher risk for HF hospitalization than their counterparts without AF (P = 0.02); this relationship remained significant following multivariable competing risk regression with propensity score weighting (hazard ratio 2.53, P = 0.04 and hazard ratio 2.91, P = 0.04, with overlap and inverse probability weighting, respectively). Although having AF appeared to increase the risk of all‐cause hospital readmission within 30 days of discharge (37.5% vs. 17.5%; P = 0.036), this relationship failed to remain significant following propensity score adjustment for clinical covariates. CONCLUSIONS: Atrial fibrillation is an independent risk factor for HF rehospitalization in HFpEF. Further understanding of the interplay between AF and HFpEF will be critical to guide the selection of appropriate rhythm management strategies in this population. John Wiley and Sons Inc. 2022-06-16 /pmc/articles/PMC9715808/ /pubmed/35712815 http://dx.doi.org/10.1002/ehf2.13836 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Yang, Eunice Vaishnav, Joban Song, Evelyn Lee, Joan Schulman, Steven Calkins, Hugh Berger, Ronald Russell, Stuart D. Sharma, Kavita Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
title | Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
title_full | Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
title_fullStr | Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
title_full_unstemmed | Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
title_short | Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
title_sort | atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715808/ https://www.ncbi.nlm.nih.gov/pubmed/35712815 http://dx.doi.org/10.1002/ehf2.13836 |
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