Abstract 15861: Natural History of Atrial Fibrillation, HF With Preserved and Reduced Ejection Fraction in Community Dwelling Older Adults
Background: Atrial fibrillation (AF) and heart failure (HF) are common in older adults. However, HF in older adults is often associated with preserved ejection fraction (HFpEF). Little is known about the natural history of AF and HFpEF in community dwelling older adults. In the current analysis, we examined the impact of AF alone, HFpEF alone and HF with reduced EF (HFrEF) alone on all-cause mortality (vs. neither AF nor HF) in Cardiovascular Health Study (CHS).
Methods: Of the 5598 Medicare-eligible community-dwelling adults aged ≥65 years in the CHS, 116 had AF only, 143 had HFpEF only, 76 had HFrEF only and 5263 had neither. Baseline AF was diagnosed by ECG and baseline HF was adjudicated by a central events committee. Cox-proportional hazards model were used to estimate age-sex-race-adjusted HR (95% CI) for all-cause mortality during 13 years of follow-up, associated with AF, HFpEF and HFrEF (vs. neither).
Results: Participants had a mean age 73 (±6) years, 58% were women and 15% were African American. All-cause mortality occurred in 43% (neither), 66% (AF only), 68% (HFpEF only), 87% (HFrEF only). Compared to those with neither condition, age-sex-race-adjusted HRs (95% Cis) for all-cause mortality for those with AF only, HFpEF only, AF and HFrEF only were 1.35 (1.07-1.70), 1.87 (1.53-2.30) and 3.32 (2.60-4.24), resp (Figure).
Conclusions: Compared to community-dwelling older adults without AF or HF, those with AF had a 35% higher risk of death that was observed 6 years after baseline. In contrast, HFpEF was associated with an 87% higher risk of death that was apparent soon after baseline and HFrEF was associated with the highest risk of death (232%).
Author Disclosures: V. Bhatia: None. N. Bajaj: None. P. Deedwania: None. S. Ather: None. S.D. Prabhu: Research Grant; Significant; NIH and VA grants. C.J. Morgan: None. S. Gaba: None. G.C. Fonarow: None. K. Saman: None. W.S. Aronow: None. S.D. Anker: None. R.M. Allman: None. R. Kheirbek: None. N. Shara: None. R. Fletcher: None. A. Ahmed: None.
- © 2014 by American Heart Association, Inc.