ACC 2013: Large observational study confirms heart failure patients with atrial fibrillation have worse outcomes

March 10, 2013 – The study used data from the American Heart Association’s Get With the Guidelines-Heart Failure registry.

In a large observational study comparing outcomes for heart failure (HF) patients with and without atrial fibrillation (AF), researchers have shown that HF patients with AF have worse outcomes than those with HF alone. Further examination revealed that the group of patients with HF and preexisting AF had a higher rate of hospital readmission than those with HF alone.

This study was led by DCRI fellow Prateeti Khazanie, MD, MPH; Jonathan Piccini, MD, MHS; Adrian Hernandez, MD, MHS; Lesley Curtis, PhD; Laura Qualls, Brad Hammill, and Li Lang. The results were presented today at the American College of Cardiology’s Scientific Sessions in San Francisco, CA.

Khazanie explained that although previous studies have looked at the correlation between worse outcomes and AF in HF patients, this is one of the largest to look at long-term outcomes in a large registry linked with Medicare claims. This study drew data from 2006–2008 for more than 27,000 patients from the American Heart Association’s Get With the Guidelines–Heart Failure registry and linked that data with Medicare claims. The results expand on previous research and provide a “real-world” confirmation of previous findings.

As part of their analysis, the researchers also distinguished between HF patients with preserved versus reduced ejection fraction. The study results indicated that HF patients in both groups with AF had equal rates of hospital readmission due to stroke. Khazanie said these findings suggest that all HF patients, regardless of HF type, are at risk for stroke.

According to Khazanie, the study findings indicate that HF patients with preexisting AF may need to be treated more aggressively than patients with HF alone. These patients are usually sicker and further down the curve of their disease and, thus, require more aggressive treatment.