Trial reportHeart rhythm2024
The impact of atrial fibrillation on clinical outcomes in heart failure with mid-range and preserved ejection fraction patients.
Trial report in Heart rhythm, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed.
- The Prognostic Impact of the Cachexia Index in Patients Hospitalized with Heart Failure.Medicina (Kaunas, Lithuania) · 2026Article
- Risk of Stroke, Thromboembolism and Mortality in Atrial Fibrillation Patients Across Different Stages and Types of Heart Failure: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Differences in stroke risk among patients with atrial fibrillation and heart failure subtypes.Heart rhythm · 2026Article
- Vericiguat reduces atrial fibrillation recurrence by alleviating myocardial fibrosis via the TGF-β1/Smad2/3 pathway.PloS one · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundThe combined effect of left ventricular ejection fraction (LVEF) and atrial fibrillation (AF) on clinical outcomes in heart failure (HF) remains complex.
objectiveIn this post hoc analysis of the TOPCAT trial, we aimed to evaluate the impact of AF on clinical outcomes in patients with HF stratified by LVEF range.
methodsA total of 3442 patients were included, stratified into 3 groups according to LVEF range-HF with mid-range ejection fraction (HFmrEF), LVEF of 45%-50% (n = 823); HF with preserved ejection fraction (HFpEF), LVEF of 51%-60% (n = 1682); and HF with normal ejection fraction (HFnEF), LVEF >60% (n = 937)-and subdivided according to the presence of AF at enrollment. Cox regression analysis was used to define independent associations between AF and clinical outcomes.
resultsAF was prevalent in 38.6% in HFmrEF, 34.6% in HFpEF, and 33.7% in HFnEF (P = .07). AF was associated with worse primary outcome in each subgroup and with HF hospitalizations and worse cardiovascular mortality in HFpEF and HFnEF. The hazard ratio for the primary outcome in those with AF compared with sinus rhythm (SR) was 1.11 (1.01-1.22; P = .03) in HFmrEF, 1.20 (1.11-1.29; P < .001) in HFpEF, and 1.16 (1.05-1.28; P = .004) in HFnEF. When LVEF was treated as a continuous variable, there was a linear negative association between LVEF and the effect of AF vs SR for the primary end point and HF hospitalizations and a linear positive association for cardiovascular mortality.
conclusionCompared with SR, AF was independently associated with worse outcomes across all LVEF ranges.
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