Abstract 13240: The Relationship Between History of Valve Surgery and Heart Failure Event in Japanese Atrial Fibrillation Patients: The Fushimi Af Registry

Abstract

Background: We previously reported that valvular heart disease (VHD) was associated with an increased risk of hospitalization for heart failure (HF) in Japanese atrial fibrillation (AF) patients. However, the association of history of surgery for VHD with HF hospitalization remains unknown. Method: The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, which is a typical urban district of Japan. We started to enroll patients from March 2011, and follow-up data were available for 4,489 patients by the end of July 2021. In the entire cohort, 747 patients had VHD. We divided them to surgery group (n=182) and non-surgery group (n=565). We compared clinical characteristics and incidence rates of HF hospitalization between two groups. Result: Patients who received valve surgery were younger (72.0 years vs. 78.0 years, p<0.001), had lower systolic blood pressure (118 mmHg vs. 123 mmHg, p=0.02) and pulse rate (75.5 bpm vs. 79.1 bpm, p=0.003), more often paroxysmal type (46.7% vs. 31.0%, p<0.001), less likely to have hypertension (51.1% vs. 66.2%, p<0.001) and had lower CHADS2 score (2.09 vs. 2.55, p<0.001) than non-surgery group. Body weight, sex, prior HF, chronic kidney disease and prescription data were comparable between two groups. During the median follow-up of 1,679 days, the incidence rate of HF hospitalization was lower in surgery group than non-surgery group (2.58% vs. 4.43% per person-year, respectively, log rank p=0.001). On multivariate Cox regression analysis, history of surgery was not significantly associated with a lower risk of HF hospitalization (adjusted hazard ratio 0.76; 95% confidence interval 0.52-1.12, p=0.16). Conclusion: The incidence rate of HF hospitalization was lower in patients with valve surgery than non-surgery group. However, history of valve surgery was not independently associated with a lower risk of HF hospitalization in Japanese AF patients.