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Comparisons of clinical outcomes in patients with heart failure with preserved ejection fraction with and without atrial fibrillation: Results from a multicenter PURSUIT-HFpEF registry

Session Poster Session 7

Speaker Masaharu Masuda

Congress : ESC Congress 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure - Clinical
  • Session type : Poster Session
  • FP Number : P6356

Authors : M Masuda (Amagasaki,JP), T Kanda (Amagasaki,JP), M Asai (Amagasaki,JP), T Mano (Amagasaki,JP), T Yamada (Osaka,JP), Y Yasumura (Amagasaki,JP), M Uematsu (Osaka,JP), S Hikoso (Suita,JP), D Nakatani (Suita,JP), S Tamaki (Osaka,JP), Y Higuchi (Osaka,JP), Y Nakagawa (Kawanishi,JP), H Fuji (Kobe,JP), H Abe (Osaka,JP), Y Sakata (Suita,JP)

Authors:
M Masuda1 , T Kanda1 , M Asai1 , T Mano1 , T Yamada2 , Y Yasumura3 , M Uematsu4 , S Hikoso5 , D Nakatani5 , S Tamaki2 , Y Higuchi6 , Y Nakagawa7 , H Fuji8 , H Abe4 , Y Sakata5 , 1Kansai Rosai Hospital, Cardiovascular Center - Amagasaki - Japan , 2Osaka General Medical Center - Osaka - Japan , 3Amagasaki Central Hospital - Amagasaki - Japan , 4Osaka National Hospital - Osaka - Japan , 5Osaka University Graduate School of Medicine, Cardiology - Suita - Japan , 6Osaka Police Hospital - Osaka - Japan , 7Kawanishi city hospital - Kawanishi - Japan , 8Kobe ekisaikai hospital - Kobe - Japan ,

Citation:

Background: The presence of atrial fibrillation (AF) has been demonstrated to be associated with poor clinical outcomes in heart failure patients with reduced ejection fraction.

Objective: This study aimed to elucidate the impact of the presence of atrial fibrillation (AF) on the clinical characteristics, therapeutics, and outcomes in patients with heart failure and preserved ejection fraction (HFpEF).

Methods: PURSUIT-HFpEF is a multicenter prospective observational study including patients hospitalized for acute heart failure with left ventricular ejection fraction of >50%. Patients with acute coronary syndrome or severe valvular disease were excluded.

Results: Of 486 HFpEF patients (age, 80.8±9.0 years old; male, 47%) from 24 cardiovascular centers, 199 (41%) had AF on admission. Patients with AF had lower systolic blood pressures (142±27 vs. 155±35mmHg, p<0.0001) and higher heart rates (91±29 vs. 82±26bpm, p<0.0001) than those without. There was no difference in the usage of inotropes or mechanical ventilation between the 2 groups. A higher quality of life score (EQ5D, 0.72±0.27 vs. 0.63±0.30, p=0.002) was observed at discharge in patients with than without AF. In addition, AF patients tended to demonstrate lower in-hospital mortality rates (0.5% vs. 2.4%, p=0.09) and shorter hospital stays (20.3±12.1 vs. 22.6±18.4 days, p=0.09) than those without. During a mean follow up of 360±111 days, mortality (14.1% vs. 15.3) and heart failure re-hospitalization rates (13.1% vs. 13.9%) were comparable between the 2 groups.

Conclusion: In contrast to heart failure patients with reduced ejection fraction, AF on admission was not associated with poor long-term clinical outcomes among HFpEF patients. Several in-hospital outcomes were better in patients with AF than in those without.



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