Influence of atrial fibrillation on the mortality of patients with heart failure with preserved ejection fraction

Meta-Analysis of Atrial Fibrillation and Outcomes in Patients With Heart Failure and Preserved Ejection Fraction

“…According to NOS, five studies included in this metaanalysis were considered to be of low quality [11][12][13]16,21]. These studies did not match for age, sex or other confounders between the AF group and the non-AF group.…”

“…These studies did not match for age, sex or other confounders between the AF group and the non-AF group. In addition, in the studies by Franco et al [11] and Goyal et al [12] the description of exposure to AF was not very clear and the assessment of outcomes was not rigorous, and in the study by Eapen et al [16] the patients were monitored for only 1 month. Thus, the selection and performance bias may have influenced the results.…”

“…Most of the studies were controlled for major confounders (namely: age, sex, New York Heart Association functional class, and history of cardiovascular disease) and reported the adjusted HRs, except for the studies by Fung et al [21], Linssen et al [19], Elshazly et al [13], and Franco et al [11]. Based on the NOS, nine studies had a total score of 6 points, and five studies had a score ,6 points [11][12][13]16,21], indicating a high risk of bias. The main characteristics of the selected studies are presented in Table 1.…”

“…Hospitalisation for worsening HF was reported in seven studies [9,11,16,18,19,21,22], cardiovascular death was reported in three studies [9,11,22] and stroke was reported in five studies [9,15,16,18,22]. As demonstrated in Figure 4, AF was associated with an increase in hospitalisation for worsening HF (HR 1.32, 95% CI 1.15-1.52, I 2 =57.1%), cardiovascular death (HR 1.38, 95% CI 1.01-1.89, I 2 =71.7%) and stroke (HR 1.87, 95% CI 1.54-2.27, I 2 =9.0%).…”

“…It has been speculated that AF might have a great influence on clinical outcomes in patients with HFpEF. Although many previous studies have addressed the prognostic impact of AF in patients with HFpEF, the results have been inconsistent [9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Therefore, this meta-analysis of the published data was conducted to evaluate the relationship between AF and mortality risk in HFpEF.…”