Table 2.
Characteristics of patients hospitalized for heart failure with mildly reduced or heart preserved ejection fraction by atrial fibrillation status
| Variable | AF history (n = 216 486) |
No AF (n = 212 978) |
% Std. diff. |
|---|---|---|---|
|
|
|
|
|
| Demographics | |||
| Age, years, median (25th– 75th) | 80 (71 – 87) | 71 (60 – 81) | 62.4 |
| Female sex | 120 743 (55.8) | 124 681 (58.5) | |
| Race/ethnicity | 46.6 | ||
| White | 173 889 (80.3) | 128 219 (60.2) | |
| Black | 22 824 (10.5) | 53 174 (25.0) | |
| Hispanic (any race) | 10 599 (4.9) | 19 952 (9.4) | |
| Asian | 4265 (2.0) | 5024 (2.4) | |
| Other | 4909 (2.3) | 6609 (3.1) | |
| Insurance status | 26.4 | ||
| Medicare– private/HMO/other | 44 589 (20.6) | 37 021 (17.4) | |
| Medicare | 81 509 (37.7) | 67 814 (31.8) | |
| Medicaid | 22 262 (10.3) | 39 146 (18.4) | |
| Private/HMO/other | 57 460 (26.5) | 54 129 (25.4) | |
| No insurance/ND/UTD/missing | 10 666 (4.9) | 14 868 (7.0) | |
| Ejection fraction | |||
| EF, %, median (25th– 75th) | 57 (50 – 62) | 58 (52 – 63) | 7.1 |
| EF group | 0.4 | ||
| HFmrEF (EF 41 – 49%) | 38 934 (18.0) | 37 952 (17.8) | |
| HFpEF (EF >50%) | 177 552 (82.0) | 175 026 (82.2) | |
| AF profile | |||
| Medical history of AF | 187 794 (86.7) | – | – |
| Medical history of atrial flutter | 17 661 (8.2) | – | – |
| Medical history of AF or atrial flutter | 192 433 (88.9) | – | – |
| AF (at presentation or during hospitalization) | 149 178 (69.3) | – | – |
| Atrial flutter (at presentation or during hospitalization) | 19 806 (9.2) | – | – |
| AF (at presentation or during hospitalization) | 156 305 (72.7) | – | – |
| History of AF but no AF at presentation or during hospitalization | 60 181 (27.8) | – | – |
| New-onset AF (AF at presentation or during hospitalization but no history of AF) | 24 053 (11.1) | – | – |
| Medical history | |||
| COPD or asthma | 85 286 (39.4) | 82 426 (38.7) | 1.4 |
| Diabetes mellitus | 93 918 (43.4) | 119 639 (56.2) | 25.8 |
| Hyperlipidaemia | 133 060 (61.5) | 123 754 (58.1) | 6.9 |
| Hypertension | 189 441 (87.5) | 190 232 (89.3) | 5.7 |
| Peripheral vascular disease | 27 359 (12.6) | 25 229 (11.8) | 2.4 |
| CAD | 101 665 (47.0) | 89 211 (41.9) | 10.2 |
| Prior MI | 35 300 (16.3) | 36 195 (17.0) | 1.8 |
| CVA/TIA | 42 042 (19.4) | 33 737 (15.8) | 9.4 |
| Anaemia | 61 524 (28.4) | 60 304 (28.3) | 0.2 |
| Dialysis, chronic | 7070 (3.3) | 16 207 (7.6) | 19.2 |
| Renal insufficiency, chronic (SCr >2.0 mg/dl) | 54 996 (25.4) | 66 336 (31.1) | 12.8 |
| Ischaemic aetiology of HF | 109 540 (50.6) | 97 133 (45.6) | 10.0 |
| Smoking | 18 292 (8.5) | 36 059 (17.1) | 25.9 |
| Discharge vital signs, laboratory measurements, and medications | |||
| Heart rate, bpm | 75 (66 – 86) | 74 (66 – 84) | 5.6 |
| SBP, mmHg | 124 (111 – 139) | 132 (118–148) | 36.2 |
| BMI, kg/m2 | 29.4 (24.6 – 36.1) | 31.2 (25.5 – 38.9) | 17.6 |
| Sodium, mEq/L | 139 (136 – 141) | 139 (136 – 141) | 1.1 |
| eGFR, ml/min/1.73 m2 | 49.8 (33.5 – 69.6) | 46.2 (25.9 – 70.8) | 12.4 |
| Potassium, mEq/L | 4.0 (3.7 – 4.3) | 4.1 (3.8 – 4.4) | 16.4 |
| NT-proBNP, pg/ml | 3938 (2006 – 7972) | 3321 (1285 – 8913) | 13.2 |
| SCr, mg/dl | 1.3 (0.9 – 1.7) | 1.4 (1.0–2.2) | 18.8 |
| Haemoglobin, g/dl (admission data only) | 11.3 (9.9 – 12.8) | 11.1 (9.6 – 12.7) | 8.2 |
| ACEi/ARB or ARNI | 76 729 (37.6) | 90 795 (44.8) | 15.4 |
| Beta-blocker | 161 183 (77.8) | 157 677 (76.2) | 8.4 |
| Aldosterone antagonist | 30 068 (14.7) | 24 275 (11.9) | 10.4 |
| Digoxina | 8267 (9.9) | 903 (1.1) | 39.3 |
| Hospital characteristics | |||
| No. of beds, median (25th– 75th) | 361 (226 – 537) | 376 (232 – 539) | 7.5 |
| Geographic region | 12.6 | ||
| West | 31 784 (14.7) | 33 003 (15.5) | |
| South | 62 672 (28.9) | 72 134 (33.9) | |
| Midwest | 55 291 (25.5) | 51 828 (24.3) | |
| Northeast | 66 739 (30.8) | 56 013 (26.3) | |
| Rural location | 7088 (3.3) | 7206 (3.4) | 0.6 |
| Teaching status | 165 740 (76.6) | 163 807 (76.9) | 0.8 |
Values are mean ± standard deviation, n (%), or median (interquartile range).
ACEi, angiotensin-converting enzyme inhibitor; AF, atrial fibrillation; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor– neprilysin inhibitor; BMI, body mass index; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; CVA, cardiovascular accident; EF, ejection fraction; eGFR, estimated glomerular filtration rate; HF, heart failure; HFmrEF, heart failure with mildly reduced ejection fraction; HMO, Health Maintenance Organization; HFpEF, heart failure with preserved ejection fraction; MI, myocardial infarction; ND, not defined; NT-proBNP, N-terminal pro-B-type natriuretic peptide; SBP, systolic blood pressure; SCr, serum creatinine; TIA, transient ischaemic attack; UTD, unable to determine.
Data available in 265 810 (61.9%) of participants.