Title:Evaluation of Clinical, Echocardiographic, and Therapeutic Characteristics,
and Prognostic Outcomes of Coexisting Heart Failure among Patients with
Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study
Volume: 22
Issue: 1
Author(s): Nasr Alrabadi*, Mohammed Al-Nusair, Farah K. El-zubi, Mais Tashtoush, Osama Alzoubi, Sa’ed Khamis, Majd M. Masadeh, Karem H. Alzoubi, Mohammed Al-Hiari and Ayman Hammoudeh*
Affiliation:
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
- Cardiology Department, Istishari
Hospital, Amman, Jordan
Keywords:
Heart failure, atrial fibrillation, patients, Jordan, JoFib study, echocardiographic.
Abstract:
Background: Atrial fibrillation (AF) is the most commonly encountered cardiac arrhythmia
in clinical practice. Heart failure (HF) can occur concurrently with AF.
Aim: We compared different demographic, clinical, and echocardiographic characteristics between
patients with AF+HF and patients with AF only. Furthermore, we explored whether concurrent HF
independently predicts several outcomes (all-cause mortality, cardiovascular mortality, ischemic
stroke/systemic embolism (IS/SE), major bleeding, and clinically relevant non-major bleeding
(CRNMB)).
Materials and Methods: Comparisons between the AF+HF and the AF-only group were carried out.
Multivariable Cox proportional hazard models were constructed for each outcome to assess whether
HF was predictive of any of them while controlling for possible confounding factors.
Results: A total of 2020 patients were included in this study: 481 had AF+HF; 1539 had AF only.
AF+HF patients were older, more commonly males, and had a higher prevalence of diabetes mellitus,
dyslipidemia, coronary artery disease, and chronic kidney disease (p≤0.05). Furthermore, AF+HF
patients more commonly had pulmonary hypertension and low ejection fraction (p≤0.001). Finally,
HF was independently predictive of all-cause mortality (adjusted HR 2.17, 95% CI (1.66-2.85) and
cardiovascular mortality (adjusted HR 2.37, 95% CI (1.68-3.36).
Conclusion: Coexisting AF+HF was associated with a more labile and higher-risk population among
Jordanian patients. Furthermore, coexisting HF independently predicted higher all-cause mortality
and cardiovascular mortality. Efforts should be made to efficiently identify such cases early and treat
them aggressively.