Abstract 16235: The Impact of Atrial Fibrillation on Heart Failure With Preserved versus Reduced Ejection Fraction in the Middle East Region: Insights From the Gulf aCute heArt failuRe rEgistry (Gulf CARE)
Background: Atrial Fibrillation (AF) and heart failure (HF) are two common prevalent conditions that may present independent of each other or coexist. The impact of AF on mortality in patients with HF and reduced (HFrEF) or preserved ejection fraction (HFpEF) is unclear with conflicting results.
Methods: We analyzed data from the Gulf acute HF registry, a prospective, multinational registry of patients admitted with acute HF in 47 hospitals in 7 Middle Eastern Arab Gulf countries (recruited between February 13, 2012 and November 13, 2012). We compared the 12-month mortality in patients with AF versus sinus rhythm (SR) in both types of HF (HFrEF and HFpEF).
Results: Among 5005 patients admitted with HF, 835 patients (16.7%) had AF and 3964 (79.2 %) had no history of AF and were in SR. Remaining percentage included patients with rhythms other than AF or SR (e.g. junctional rhythm). After excluding patients with no available echocardiography and those with other rhythms, the number of patients in our study population was 4394 patients where 770 patients (17.5 %) were in the AF group ( 10.2% with HFrEF and 7.3% with HFpEF) and 3624 patients (82.5 %) were in the SR group (56.2% with HFrEF and 26.3% with HFpEF). The mortality at 12 month was significantly higher in the AF compared to SR group (21.1% vs. 16.3%; P = 0.001), even after covariate adjustment (odds ratio [OR] = 1.23, 95% C.I 1.01-1.5; P = 0.04). Furthermore, subgroup analysis revealed that AF was associated with a higher risk of 12 month mortality in patients with HFrEF (23.7% vs. 16.6%; P = 0.001) but not among patients with HFpEF (17.5% vs. 15.8%; P = 0.48), even after covariate adjustment (adjusted OR among patients with HFrEF = 1.40, 95% C.I. 1.10-1.80; P=0.009 while adjusted OR among patients with HFpEF = 0.93. 95% C.I.:0.65 - 1.32; P=0.67).
Conclusion: AF is associated with significantly higher 12-month mortality among patients with HFrEF, but not among those with HFpEF, suggesting a stronger impact of AF in patients with systolic HF.
Author Disclosures: N.A. Asaad: None. K. Sulaiman: None. M.K. Mohsen: None. J. Al-Suwaidi: None. A. Alsheikh-Ali: Other Research Support; Modest; Medtronic, Behringer Ingelheim. Honoraria; Modest; Boehringer Ingelheim, Bayer, Pfizer. D. Darbar: None. R. Singh: None. K.F. AlHabib: None. H. AlFaleh: None. A. Elasfar: None. A. Al-Motarreb: None. P. Panduranga: None. W. Almahmeed: None. N. Bazargani: None. M. Ridha: None. B. Bulbanat: None. M. Al-Jarallah: None. H. Amin: None. C. Bollensdorff: None. A.M. Salam: None. M. Yacoub: None.
- © 2014 by American Heart Association, Inc.