Atrial fibrillation types and poor prognosis in patients with heart failure with preserved ejection fraction complicated by metabolic syndrome:a study on correlation
Ma Yanhong
Liang Jinjin
Wang Rui
Abstract：Objective To investigate the influence of types of atrial fibrillation(AF)on risk of major adverse cardiovascular events(MACE)in patients with heart failure with preserved ejection fraction(HFpEF)complicated by metabolic syndrome(MS).Methods In this multicenter retrospective cohort study,the patients with HFpEF complicated by MS(n=1146)were chosen from the First Hospital of Zhangjiakou City and the First Affiliated Hospital of Hebei North University from May 2021 to May 2023.The patients were divided,according to AF types at admission time,into non-AF group(n=804),group of paroxysmal atrial fibrillation(PAF group,n=207)and group of persistent atrial fibrillation(PeAF group,n=135).The primary endpoint was MACE occurrence,and the secondary endpoints were cardiovascular death and readmission due to HF.The relationship between different AF types and outcomes was reviewed by using survival analysis.Log-rank P values were calculated after plotted Kaplan-Meier curves in all groups.The relationship between different AF types and MACE risk was studied by using Cox regression analysis.Results The incidence rates of MACE and readmission due to HF were significantly higher in PAF group and PeAF group than those in non-AF group(P<0.05).The results of survival analysis showed that MACE incidence(P<0.001)and readmission due to HF(P<0.001)increased significantly in in PAF group and PeAF group compared with non-AF group,while the difference had no statistical significance between PAF group and PeAF group(P>0.05).The results of Cox regression analysis showed that PAF(HR 1.76,95%CI:1.03～2.40,P<0.001)and PeAF(HR:1.87,95%CI:1.34～2.61,P<0.001)were independent risk factors of MACE.Conclusion In patients with HFpEF complicated by MS,MACE risk is significantly higher in those with PAF or PeAF compared to those without AF,suggesting that AF is an independent risk factor for poor prognosis in this population.
Keywords：Heart failure with preserved ejection fractionMetabolic syndromeAtrial fibrillation typesParoxysmal atrial fibrillationPersistent atrial fibrillation
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 333-337,341 )