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Anticoagulation in Patients with AF and HF

Clin Cardiol; ePub 2018 Dec 23; Contreras, et al

Patients with non-valvular atrial fibrillation (NVAF) and heart failure with reduced ejection fraction (HFrEF) have significantly lower anticoagulation rates when compared to their HFrEF counterparts, a recent study found. Researchers analyzed the outpatient NCDR PINNACLE-AF registry to identify patients with NVAF and congestive heart failure (CHF). The study population was subdivided into heart failure with preserved ejection fraction (HFpEF) and HFrEF. Anticoagulation rates by CHF group were compared and stratified by CHA2DS2-VASc score. They found:

  • 340,127 patients with NVAF and CHF were identified, of whom 248,136 (73.0%) were classified as HFpEF and 91,991 (27.0%) as HFrEF.
  • Patients with HFpEF had higher mean CHA2DS2-VASc scores and were more likely to be female, older, and have hypertension.
  • Unadjusted anticoagulation rates were significantly lower in patients with HFpEF vs those with HFrEF.


Contreras JP, Hong KN, Castillo J, et al. Anticoagulation in patients with atrial fibrillation and heart failure: Insights from the NCDR PINNACLE-AF Registry. [Published online ahead of print December 23, 2018]. Clin Cardiol. doi:10.1002/clc.23142.