Table 4.
Sensitivity Analysis Defining HFpEF as LVEF≥40%: Association of Atrial Fibrillation With Incident Heart Failure Events
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| Model 1 | Model 2 | Model 3 | Model 4 | ||||
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| HF Group* | n events / n at risk | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | χ2 p For Subtype Difference | |
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| Overall | LVEF <40% | 388/ 25,787 | 2.87 (2.22, 3.72) | 2.35 (1.78, 3.11) | 2.01 (1.48, 2.72) | 1.85 (1.36, 2.51) | 0.366 |
| LVEF ≥40% | 433/ 25,787 | 2.33 (1.80, 3.02) | 1.84 (1.39, 2.42) | 1.61 (1.20, 2.17) | 1.52 (1.13, 2.05) | ||
| Women † | LVEF <40% | 141/14,176 | 2.89 (1.90, 4.40) | 2.22 (1.39, 3.55) | 2.16 (1.33, 3.51) | 2.20 (1.35, 3.57) | 0.114 |
| LVEF ≥40% | 224/14,176 | 2.57 (1.83, 3.63) | 2.23 (1.54, 3.23) | 2.05 (1.40, 3.01) | 2.03 (1.39, 2.98) | ||
| Men † | LVEF <40% | 247/11,611 | 2.84 (2.05, 3.94) | 2.50 (1.77, 3.54) | 1.94 (1.30, 2.89) | 1.72 (1.16, 2.56) | 0.803 |
| LVEF ≥40% | 209/11,611 | 1.96 (1.32, 2.92) | 1.43 (0.93, 2.17) | 1.15 (0.72, 1.85) | 1.04 (0.65, 1.68) | ||
| Black ‡ | LVEF <40% | 146/10,310 | 2.89 (1.85, 4.52) | 1.88 (1.14, 3.10) | 1.75 (1.05, 2.92) | 1.78 (1.07, 2.98) | 0.334 |
| LVEF ≥40% | 173/10,310 | 1.99 (1.25, 3.18) | 1.73 (1.06, 2.83) | 1.64 (1.00, 2.70) | 1.58 (0.96, 2.61) | ||
| White ‡ | LVEF <40% | 242/15,477 | 2.74 (2.00, 3.76) | 2.51 (1.79, 3.52) | 2.12 (1.44, 3.13) | 1.97 (1.34, 2.91) | 0.745 |
| LVEF ≥40% | 260/15,477 | 2.44 (1.79, 3.34) | 1.86 (1.33, 2.61) | 1.61 (1.11, 2.33) | 1.51 (1.04, 2.20) | ||
Abbreviations: AF, atrial fibrillation; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; HFpEF, heart failure with preserved ejection fraction; EF, ejection fraction; HR, hazard ratio; CI, confidence interval
Covariates in Multivariable Models:
Model 1: age, sex, race, income, education, & region
Model 2: Model 1 covariates + smoking (pack-years), systolic blood pressure, diabetes mellitus, body mass index (continuous), low-density lipoprotein, left ventricular hypertrophy, estimated glomerular filtration rate, antihypertensive drug use, and coronary heart disease history.
Model 3: Model 2 covariates + aspirin, warfarin, and statin use.
Model 4: Model 3 covariates + incident coronary heart disease events (time-varying)
Unclassified cases were censored in the Lunn-McNeil analysis.
Model 4 AF*sex interaction p-values (cause-specific): LVEF <40%: 0.692; LVEF ≥40%: 0.022
Model 4 AF*race interaction p-values (cause-specific): LVEF <40%: 0.991; LVEF ≥40%: 0.971