066: Atrial arrhythmias in patients with heart failure and preserved ejection fraction. Results from the prospective French and Swedish KaRen study

Abstract

The prevalence of atrial arrhythmias (AAr) in patients with heart failure (HF) is high, namely in HF with preserved ejection fraction (HFpEF). KaRen study is a French and Swedish prospective registry enrolling patients with an acute HFpEF and reassessing these patients 4–8 weeks later after conventional HF treatment. We sought to define the exact prevalence and the main clinical correlates of AAr diagnosed in the patients included in KaRen. 535 patients were prospectively recruited and 58.5% had a history of AAr. Clinical characteristics, co-morbidities, risk factors, left ventricular ejection fraction, blood chemistry and drug treatment were recorded at baseline and 4–8 weeks later. The main characteristics at baseline and 4–8 weeks follow-up of the 313 pts with a history of AAr (AAr+) and of the 220 without AAr (AAr-) are displayed in the table. Patients with AAr were older (p=0.0004) and tend to have higher NT-proBNP levels at baseline. There were no significant differences for diabetes, Serum creatinin, hemoglobin or left ventricular ejection fraction. In the 313 patients AAr+, 69% were treated by beta-blockers at the admission (significantly more than in group AAr-, p=0.0034), 59.7% were treated with an ACE-inhibitor, 60% got an oral anticoagulant (p<0.0001) at baseline and 73% at the 4–8week visit. AAr are extremely prevalent in patient admitted for HFpEF. Prevalence increases with increasing age and higher blood pressure. It leads to significantly more prescription of beta-blockers. Interestinglly, NT-proBNP decreased more in AAr+ patients after treatment. Table – Main characteristics. Mediane [25 – 75 th pctl] AAr+ N= 313 (58.5%) AAr- N=220 (41.5%) p-value Age 80[73–84] 77[70–84] 0.003 Body Mass Index 28[24–32] 25[25–33] ns Left ventricular ejection fraction 55 [50–60] 55[50–60] ns Systolic blood pressure (mm Hg) 144[125–160] 151[132–180] 0.0002 NT-proBNP admission 2654 [1356–4921] 2113 [1040–4630] 0.06 NT-proBNP 4–8 weeks 1710 [819-2800] 2113 [1040-1948] <0.001