Abstract 9257: Atrial Fibrillation is Associated With Worse Outcomes in Patients With Diastolic Heart Failure than Patients With Systolic Heart Failure
Introduction: Atrial fibrillation (AF) is prevalent and is associated with heart failure (HF). HF causes changes in atrial structure and physiology that predispose to AF. Our goal was assess the impact of AF on HF patients with either preserved (HFpEF) or reduced (HFrEF) left ventricular ejection fraction (LVEF).
Hypothesis: We hypothesized that patients with HFrEF would likely have more adverse events and worse outcomes.
Methods: This was a retrospective review of 763 patients with HF at baseline who developed AF. We analyzed the CHADS and CHADS-Vasc scores and time to death, time to AF development, time to death from AF development, time to adverse events (figure 1), and length of stay (LOS).
Results: Patients with HFpEF had significantly longer LOS for AF or HF hospitalizations. While patients with HFrEF on average developed AF four months sooner than patients with HFpEF, those with HFpEF died six months earlier (table 1).
Using multiple linear regression only age was a significant predictor for time to AF development.
There were no significant differences between HFrEF vs HFpEF patients with respect to time to an adverse event. When patients were stratified into younger vs older cohorts (< or ≥ 50 years of age) there was a significant difference for the waiting time to an adverse event between the younger and older patients (figure 1).
Conclusion: Patients with HFpEF and AF represent a cohort of patients that have a significant burden of disease and poor outcomes. Their increased LOS is likely a product of their multiple co-morbid conditions complicating their underlying HF. Our data also suggests that the most important factor for time to an adverse event for HF patients with AF is age, not the LVEF.
- © 2013 by American Heart Association, Inc.