Abstract
Byline: Irfan Shafi, Wayne State Univ, Detroit, MI; Rashid Alhusain, Wayne State Univ; Abdalaziz Awadelkarim, Wayne State Univ, Detroit, MI; Chad Tidwell, Wayne State Univ, Detroit, MI; Tyler Mumm, Wayne State Univ, Detroit, MI; Tushar Mishra; Mohammed Ali, Wayne State Univ, Detroit, MI; Singh Manmohan, Wayne State Univ, Detroit, MI; Luis AFONSO, Wayne State Univ, Detroit, MI; Anupama Kottam, Wayne State Univ, Detroit, MI Background: Atrial fibrillation and heart failure with preserved ejection fraction(HFpEF) are closely interrelated, and atrial fibrillation confer poor prognosis in HFpEF patients. Objective: We sought to study outcomes and implications of atrial fibrillation among patients hospitalized with HFpEF. Methods: Patients with a principal discharge diagnosis of HFpEF between 2016 and 2018 were identified in the National Readmissions Database. Among those, patients with and without a secondary diagnosis of atrial fibrillation were categorized. HFpEF hospitalizations with atrial fibrillation were matched 1:1 fashion to HFpEF without atrial fibrillation using age, sex, and Charlson comorbidity index. Results: Of the 195,110 HFpEF hospitalizations, 66,584 had HFpEF with a secondary diagnosis of atrial fibrillation. Propensity score-matched comparison between HFpEF with and without atrial fibrillation showed higher in-patient mortality (3.18% vs. 2.58%, P=0.00), Cardiogenic shock (0.62% vs. 0.39%, P=0.00) and bleeding (2.09% vs. 1.08%, P=0.00) as compared with HFpEF without atrial fibrillation. Total charges were higher in HFpEF with atrial fibrillation compared to patients without atrial fibrillation ($ 46018.97 vs. $ 43692.16). The 30 days all-cause readmission rate among patients admitted with HFpEF and survived index hospitalization was 20.14% (95% CI 19.96 - 20.31%). Conclusion: In patients with HFpEF presence of atrial fibrillation was associated with higher inpatient mortality. Figure 1: Patient selection flow diagram Table 1: Outcomes of HFpEF Patients with and without Atrial Fibrillation in Propensity-Matched Groups.