Abstract 15946: Heart Failure With Preserved Ejection Fraction (HFpEF) and Atrial Fibrillation (AF) is Prognostically Equivalent to HF With Reduced Ejection Fraction (HFrEF) With or Without AF Among Community-Dwelling Older Adults
Background: Atrial fibrillation (AF) is common in older adults with heart failure (HF). Among community dwelling older adults, HFpEF is more common than HFrEF. However, little is known about the differential impact of AF on mortality in HFpEF vs HFrEF. In the current analysis, we examined the impact of AF on all-cause mortality in older adults with HFpEF and HFrEF in Cardiovascular Health Study (CHS).
Methods: Of the 5795 Medicare-eligible community-dwelling adults aged ≥65 years in the CHS, 274 (5%) had centrally-adjudicated HF at baseline. We excluded 16 patients with AF history but no ECG evidence. Of the remaining 258 HF patients (1) 143 had HFpEF only, (2) 28 had HFpEF with AF, (3) 76 had HFrEF only, and (4) 11 had HFrEF with AF. 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.
Results: Participants had a mean age of 75±6 years, 52% were women and 21% were African-American. All-cause mortality occurred in 68% (HFpEF only), 86% (HFpEF with AF), 87% (HFrEF only) and 82% (HFrEF with AF) of patients. Compared to those with HFpEF only, age-sex-race-adjusted HRs (95% Cis) for all-cause mortality for those with HFpEF with AF, HFrEF alone and HFrEF with were 1.52 (0.96-2.39), 1.56 (1.12-2.17), and 1.54 (0.77-3.07), resp.
Conclusions: Among community-dwelling older adults, HFpEF with AF was prognostically equivalent to HFrEF with or without AF. Although the impact of AF on HFrEF appeared to be less pronounced than its effect on HFpEF, this interpretation is limited by small sample of size of those with HFrEF and AF.
Author Disclosures: N.S. Bajaj: None. V. Bhatia: None. P. Deedwania: None. S. Ather: None. S. Gaba: None. K. Sanam: None. C. Morgan: None. S.D. Prabhu: None. G.C. Fonarow: None. R. Kheirbek: None. N. Shara: None. W.S. Aronow: None. S.D. Anker: None. R. Allman: None. R.D. Fletcher: None. A. Ahmed: None.
- © 2014 by American Heart Association, Inc.