Abstract 15335: Predictors of Mortality in Heart Failure With Preserved Ejection Fraction and Atrial Fibrillation: A Snapshot From the National Inpatient Sample 2002-2012
Introduction: Hospitalizations for Heart failure with preserved ejection fraction (HFpEF) have been increasing and they are frequently associated with history of Atrial Fibrillation (AF). Data on this common subset of HFpEF population is limited.
Methods: Nationwide Inpatient Sample (NIS) was queried to identify patients with HFpEF (ICD9-CM 428.31, 428.33) as primary or secondary diagnosis, together with AF (ICD-9CM 427.31) as a secondary diagnosis, from 2002-2012. Baseline characteristics among AF and non-AF patients were compared using t-test and chi-square tests. Multivariate logistic regression was done in the HFpEF-AF subgroup to identify independent predictors of in-patient mortality.
Results: 2,325,238 patients HFpEF were hospitalized from 2002-2012, out of which 871,997 (37.5%) had AF. HFpEF patients with AF had higher mean age compared to non-AF patients (79.9 vs. 73.3). Females are the majority of the HFpEF population (64.3%). Notable significant differences (p<0.001) between the two subgroups included: nearly half the proportions of Blacks and Hispanics were found in the AF subgroup compared to the non-AF subgroup (7.11% vs. 16.61%, 3.81% vs. 6.04%, respectively); the AF subgroup had lower prevalence of diabetes mellitus (DM) and obesity (37.07% vs. 45.39%, 15.33% vs. 20.24%, respectively) and shorter length of stay (6.78 vs 7.55 days), but a higher in-patient mortality (5.11% vs. 3.84%). Independent predictors of mortality included history of pulmonary circulatory disorders, chronic liver disease and renal failure. Coronary Artery Disease, DM, Anemia and Obesity were all negative predictors of mortality (Figure 1).
Conclusion: AF in the setting of HFpEF is a common presentation with an increasing trend. In-patient mortality in this subset of HFpEF patients is more common with concurrent lung pathologies and renal failure, whereas history of CAD offers some protection, most likely due to probable history of revascularization.
Author Disclosures: K. Agnihotri: None. A. Deshmukh: None. P. Charilaou: None. N. Patel: None. N. Patel: None. S. Arora: None. A. Badheka: None. H. Paydak: None. J. Viles-Gonzalez: None.
- © 2016 by American Heart Association, Inc.