Skip to main content
Journal cover image

Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction.

Publication ,  Journal Article
Yang, E; Vaishnav, J; Song, E; Lee, J; Schulman, S; Calkins, H; Berger, R; Russell, SD; Sharma, K
Published in: ESC Heart Fail
October 2022

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.

Duke Scholars

Published In

ESC Heart Fail

DOI

EISSN

2055-5822

Publication Date

October 2022

Volume

9

Issue

5

Start / End Page

2918 / 2927

Location

England

Related Subject Headings

  • Stroke Volume
  • Risk Factors
  • Prognosis
  • Male
  • Humans
  • Hospitalization
  • Heart Failure
  • Atrial Fibrillation
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yang, E., Vaishnav, J., Song, E., Lee, J., Schulman, S., Calkins, H., … Sharma, K. (2022). Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction. ESC Heart Fail, 9(5), 2918–2927. https://doi.org/10.1002/ehf2.13836
Yang, Eunice, Joban Vaishnav, Evelyn Song, Joan Lee, Steven Schulman, Hugh Calkins, Ronald Berger, Stuart D. Russell, and Kavita Sharma. “Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction.ESC Heart Fail 9, no. 5 (October 2022): 2918–27. https://doi.org/10.1002/ehf2.13836.
Yang E, Vaishnav J, Song E, Lee J, Schulman S, Calkins H, et al. Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction. ESC Heart Fail. 2022 Oct;9(5):2918–27.
Yang, Eunice, et al. “Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction.ESC Heart Fail, vol. 9, no. 5, Oct. 2022, pp. 2918–27. Pubmed, doi:10.1002/ehf2.13836.
Yang E, Vaishnav J, Song E, Lee J, Schulman S, Calkins H, Berger R, Russell SD, Sharma K. Atrial fibrillation is an independent risk factor for heart failure hospitalization in heart failure with preserved ejection fraction. ESC Heart Fail. 2022 Oct;9(5):2918–2927.
Journal cover image

Published In

ESC Heart Fail

DOI

EISSN

2055-5822

Publication Date

October 2022

Volume

9

Issue

5

Start / End Page

2918 / 2927

Location

England

Related Subject Headings

  • Stroke Volume
  • Risk Factors
  • Prognosis
  • Male
  • Humans
  • Hospitalization
  • Heart Failure
  • Atrial Fibrillation
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology