Relative Contribution of Atrial Fibrillation to Outcomes of Patients With Cardiomyopathy Based on Severity of Left Ventricular Dysfunction
Section snippets
Methods
This observational study was approved by the institutional review board of the University of Pittsburgh which waived the requirement to obtain consent from patients. We analyzed a cohort of 18,003 consecutive patients with cardiomyopathy (EF ≤50%) who were seen at the hospitals and clinics of the University of Pittsburgh Medical Center between January 1, 2011, and December 31, 2017. From the institutional analytics warehouse, data were collected on each patient, including baseline demographic
Results
Patient baseline characteristics, stratified by EF quartile, are listed in Table 1. It is noted that with increasing EF, the prevalence of HF decreases from 56% in quartile 1 to 33% in quartile 4 (p <0.001). The prevalence of AF, in contrast, was lowest in the lowest EF quartile compared with the other 3 quartiles (p = 0.005). Table 2 lists patient baseline characteristics, stratified by the presence or absence of AF. Patients with AF were older, more likely to be White and men, and had
Discussion
Our data demonstrate that although the risk of the primary end point of HFH and of the secondary end point of death or HFH is higher in patients with more reduced EF, the relative contribution of AF to these end points is strongest in patients with more preserved EF, suggesting that management strategies for AF in patients with more preserved LV function may be most impactful in preventing these adverse outcomes. These results are hypothesis-generating and deserved further investigation.
Declaration of Competing Interest
Dr. Saba has received research support from Abbott and Boston Scientific and reports receiving consultation payments from Boston Scientific and Medtronic. The remaining authors have no conflicts of interest to declare.
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Cited by (1)
Atrial Fibrillation and Heart Failure: Is It the Chicken or the Egg?
2023, American Journal of Cardiology
Drs. Ayub and Rangavajla contributed equally to this manuscript.
Funding: None.