In patients with atrial fibrillation (AF), heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) are both associated with higher risk of ischemic stroke, heart failure (HF), and acute myocardial infarction (AMI) admissions, even after adjusting for oral anticoagulation (OAC) use. This according to a recent study that examined the impact of HF type of thromboembolic and bleeding risk in patients with AF on OAC. Researchers used Medicare data for beneficiaries with new AF diagnosed between 2011-2013 to identify patients with HFrEF, those with HFpEF, and no HF. They found:
- The 3 groups included 47,840 (HFrEF), 32,360 (HFpEF), and 718,392 (no HF) patients, respectively.
- Patients with HFrEF and HFpEF had higher comorbidity burden, CHA2DS2-VASc and HASBLED scores vs patients without HF.
- In multivariable analysis adjusting for patient comorbidities and OAC, HFrEF and HFpEF were associated with higher risk of ischemic stroke, HF, and AMI compared to no HF.
Mentias A, Briasoulis A, Shantha G, et al. Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation. [Published online ahead of print February 28, 2019]. Am J Cardiol. doi:10.1016/j.amjcard.2019.02.027.