Yandrapalli, Srikanth;
Ojo, Amole;
Harikrishnan, Prakash;
Vuddanda, Venkat L;
Karim, Mohammed;
Aronow, Wilbert S;
Frishman, William;
Ahmed, Ali;
Fonarow, Gregg C;
Lanier, Gregg M;
Iwai, Sei;
Jacobson, Jason T
Abstract 17148: Association of Atrial Fibrillation With Short-Term Outcomes in Patients Hospitalized for Heart Failure With Preserved Ejection Fraction
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Media type:
E-Article
Title:
Abstract 17148: Association of Atrial Fibrillation With Short-Term Outcomes in Patients Hospitalized for Heart Failure With Preserved Ejection Fraction
Contributor:
Yandrapalli, Srikanth;
Ojo, Amole;
Harikrishnan, Prakash;
Vuddanda, Venkat L;
Karim, Mohammed;
Aronow, Wilbert S;
Frishman, William;
Ahmed, Ali;
Fonarow, Gregg C;
Lanier, Gregg M;
Iwai, Sei;
Jacobson, Jason T
Description:
<jats:p>
<jats:bold>Background:</jats:bold>
Atrial fibrillation (AF) is frequently present in patients with heart failure (HF) with preserved ejection fraction (HFpEF). The association of AF with short term outcomes in patients hospitalized for HFpEF is not well studied.
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<jats:p>
<jats:bold>Methods:</jats:bold>
We queried the United States Nationwide Readmissions Database year 2014 using appropriate ICD-9 codes to identify a weighted sample of adult patients hospitalized for HFpEF. Patients with concomitant diagnoses of HF with reduced ejection fraction (HFrEF) were excluded. The primary outcome was a composite of in-hospital death or a 30-day readmission for HF. Secondary outcomes studied were individual outcomes along with composites of in-hospital death or a 30-day readmission for any cause or cardiac etiologies. Survey specific adjusted multivariable logistic regression models were used to analyze the association of AF with outcomes.
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<jats:p>
<jats:bold>Results:</jats:bold>
Of 229,098 patients (mean age 76 years, 38% men) who were hospitalized for HFpEF during the study period, AF was present in 45.3% (N=103,852). Patients with AF were older (mean age 80 vs 72 years, p<.001) and more likely men (39% vs 37.5%, p<.001) compared to patients without AF. Primary outcome occurred in 9.5% patients with AF and in 8.0% patients without AF (p<0.001). After adjusting for patient demographics, comorbidities, complications, and hospital characteristics, AF was associated with 17% higher odds of the primary outcome (OR 1.17, 95% CI 1.11-1.23), 20% higher odds of in-hospital death (OR 1.20, 95% CI 1.07-1.34), and 17% higher odds of a 30-day readmission for HF (OR 1.17, 95% CI 1.10-1.25). Similar results were noted for other outcomes;
<jats:bold>TABLE</jats:bold>
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<jats:bold>Conclusion:</jats:bold>
AF was associated with significantly worse short-term outcomes in patients hospitalized for HFpEF. Additional strategies are needed to improve outcomes in HFpEF patients with AF. Future prospective studies need to examine if AF ablation in HFpEF may improve outcomes as in HFrEF.
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