Propensity Score Matching Model Research Articles

Impact of Tobacco Taxation on Rural-Urban Cigarette Consumption in Indonesia

Tobacco taxes in Indonesia have always been increasing over the past period. However, little was known about the impact of increasing tobacco taxes on cigarette consumption in urban and rural communities. Therefore, we examine the impact of implementing tobacco taxation policies in Indonesia on cigarette consumption levels in urban and rural areas. This study uses panel data for the 2007–2022 period from 33 provinces in Indonesia. Data were sourced from the Central Bureau of Statistics of the Republic of Indonesia and the Ministry of Finance of the Republic of Indonesia and were analyzed using the two-stage least squares (2SLS) model and the propensity score matching (PSM) model. Our finding shows that increased tobacco taxes negatively impact cigarette consumption in urban and rural areas. Even so, the decline in cigarette consumption in urban areas is still much lower than the reduction in rural areas.

ESG performance and corporate fraudulence: Evidence from China

By adopting a large sample of Chinese public listed firms from 2014 to 2021, we examine whether firms' ESG performance inhibits corporate fraud. Using panel data regression techniques, we find that high ESG performance mitigates corporate fraudulence. After conducting a series of robustness tests, including propensity score matching (PSM) model, Heckman two-step sample selection model, instrumental variable (IV) and 2SLS regression model, and firm fixed effect model, the results remain unchanged. Further analyses suggest that this negative relationship is more pronounced in non-state-owned enterprise (non-SOE) firms and firms that voluntarily disclose ESG information. The mechanism analysis suggests that high-quality ESG engagement improves firms' governance performance and inhibits managerial myopia, which thereby mitigates corporate fraud. Overall, our findings provide incremental evidence on the role of ESG in filling institutional voids in emerging economies. Our findings also provide significant policy implications to regulators and policy makers who seek to promote fair information disclosure and mitigate corporate fraud risk.

Immediate application of frozen-thawed embryo transfer cycle in month following COVID-19 infection does not impair subsequent pregnancy outcomes.

To investigate whether immediate frozen embryo transfer (FET) in the next month following COVID-19 recovery affects the subsequent pregnancy outcomes. A retrospective cohort study was carried out at a university-affiliated reproductive medicine center. The study group (post-COVID-19 group) consisted of women who were afflicted with COVID-19 in December 2022 and immediately invested in FET in January 2023 after recovery, with embryos transferred and not exposed to the infection. The control group was composed of women treated during the pre-COVID-19 period (January 2019). Multivariable logistic regression analyses as well as a propensity score matching (PSM) approach were introduced to control for the potential confounders and selection bias. A total of 200 patients were included in the post-COVID-19 group while a total of 641 women were enrolled in the control group. The rate of ongoing pregnancy was comparable between the study cohorts in both the unadjusted and confounder-adjusted logistic regression models. The other reproductive outcomes, including the odds of the positive pregnancy test, implantation, clinical pregnancy, and early pregnancy loss were all similar between the comparison groups. Results from PSM models further confirmed the lack of significant differences in pregnancy outcomes between the post-COVID-19 group versus the control group. Our findings suggested that for patients who get infected with COVID-19, the immediate investment in a FET cycle in the next month after recovery did not seem to compromise the ongoing pregnancy outcomes in cases of transferred embryos resulting from the pre-infection stage. Thus, women who had frozen embryos from the pre-infection cycles should be counseled and encouraged to invest in IVF as soon as possible after recovering from COVID-19 infection. This article is protected by copyright. All rights reserved.

Oral Antibiotics Alone versus Oral Antibiotics Combined with Mechanical Bowel Preparation for Elective Colorectal Surgery: A Propensity Score-Matching Re-Analysis of the iCral 2 and 3 Prospective Cohorts.

The evidence regarding the role of oral antibiotics alone (oA) or combined with mechanical bowel preparation (MoABP) for elective colorectal surgery remains controversial. A prospective database of 8359 colorectal resections gathered over a 32-month period from 78 Italian surgical units (the iCral 2 and 3 studies), reporting patient-, disease-, and procedure-related variables together with 60-day adverse events, was re-analyzed to identify a subgroup of 1013 cases (12.1%) that received either oA or MoABP. This dataset was analyzed using a 1:1 propensity score-matching model including 20 covariates. Two well-balanced groups of 243 patients each were obtained: group A (oA) and group B (MoABP). The primary endpoints were anastomotic leakage (AL) and surgical site infection (SSI) rates. Group A vs. group B showed a significantly higher AL risk [14 (5.8%) vs. 6 (2.5%) events; OR: 3.77; 95%CI: 1.22-11.67; p = 0.021], while no significant difference was recorded between the two groups regarding SSIs. These results strongly support the use of MoABP for elective colorectal resections.

Impact of urban productive safety net programme on poverty reduction and food security: Evidence from major cities of Eastern Ethiopia (Dire Dawa, Harar and Jigjiga)

AbstractDifferent social protection programs are designed in low‐income countries to eradicate poverty and improve the food security of poor people. Currently, the Urban Productive Safety Net Program (UPSNP) is designed to support those who are living in poverty and face food insecurity with predictable and reliable support through food, cash, or vouchers. However, limited empirical evidence has been presented about the significant impact of the program on the well‐being of households who participated in the program and the factors that affect the households' decision to participate in the program. Hence, this study aims to evaluate the impact of participation in UPSNP on well‐being using household survey data gathered from three main cities of Ethiopia: Dire Dawa, Harar, and Jigjiga in 2022. This study employed both propensity score matching (PSM) and endogenous switching regression (ESR) models to assess the impact of the UPSNP. The result shows that the probability of a household's participation decision is determined by the age of the household head, number of children, savings, house ownership, employment status of the household head, and shock. Furthermore, we found a consistently positive impact across models, indicating that participation in UPSNP reduces poverty and increases food security of households.

SARS-CoV-2 Infection Is an Independent Risk Factor for Decompensation in Cirrhosis Patients.

SARS-CoV-2 causes varied gastrointestinal symptoms. Cirrhosis patients face higher mortality rates from it, especially those with decompensated cirrhosis. This study examines SARS-CoV-2's impact on decompensation in previously compensated cirrhotic patients. We analyzed the Global Collaborative Network, comprising 98 healthcare organizations across sixteen countries, using TriNetX's deidentified research database. Compensated cirrhosis patients were split into two groups: one with SARS-CoV-2-positive patients and another testing negative. Using a 1:1 propensity score matching model based on baseline characteristics and comorbidities, we created comparable cohorts. We then assessed decompensation, mortality, and GI bleed at 1 and 3 months. Out of 252,631 identified compensated cirrhosis patients, 27.3% (69,057) tested SARS-CoV-2-positive, while 72.6% (183,574) remained negative. Post PSM, 61,963 patients were in each group. SARS-CoV-2-positive patients showed significantly higher decompensation rates (4.4% vs. 1.9% at 1 month; 6% vs. 2.6% overall). Rates of complications, like ascites, SBP, HE, and HRS, increased notably. Mortality (2.5% vs. 1.7% at 1 month; 3.6% vs. 2.7% at 3 months) and GI bleed (1.3% vs. 0.9% at 1 month; 1.9% vs. 1.2% at 3 months) were also elevated in SARS-CoV-2 patients. SARS-CoV-2 increases decompensation over 2-fold in compensated cirrhosis patients and raises mortality and increases rates of complications at 1 and 3 months.

Participation in village savings and lending associations and rice profitability in Tanzania: Application of propensity score matching and endogenous switching regression

We assess the contribution of participation in bundled service-bundled VSLAs on rice productivity and profit among smallholder rice farmers in Mvomero District, Tanzania. The study propensity score matching (PSM) and endogenous switching regression (ESR) models, and found that participation in VSLA has a positive and significant contribution to rice productivity and profit for smallholder rice farmers. Participation in VSLAs increases farmers' ability to regenerate income for investing in improving productivity and profitability and enhancing rice sector development. VSLAs prove as a tool for building financial capital through savings and easy access to credit in rural areas. This study improves on existing research and offers new insights into the effects of VSLA as one of the financial inclusion tools on the economic activities of agricultural households in Tanzania.

Corporate governance report compliance rate and accounting conservatism: New evidence from Korea

This study investigates the relationship between the corporate governance report (CGR) compliance rate and a company’s accounting conservatism, utilizing the CGR compliance rate as a novel method to evaluate the effectiveness of corporate governance practices. Given the challenges of applying global indices to measure corporate governance in the Korean market, this study focuses on the CGR compliance rate as a key indicator. Utilizing the ordinary least squares (OLS) regression model, specifically the Ball and Shivakumar (2005) model widely employed in previous studies to assess accounting conservatism, this paper conducts empirical analyses based on 784 observations from Korean listed firms between 2018 and 2021. The main analysis reveals a positive association between the CGR compliance rates (coef = –2.416, p-value < 0.01) and accounting conservatism. A fixed-effect model and a propensity score matching (PSM) model also show a positive association between the CGR compliance rates, respectively (coef = –2.507, p-value < 0.01; coef = –3.118, p-value < 0.1) and accounting conservatism. This study proves that firms with high CGR compliance rates tend to promptly recognize financial losses in financial reporting, thereby safeguarding investors. This suggests that investors should consider the CGR compliance rates when evaluating potential investments. Overall, these findings contribute to validating the CGR compliance rates as a valuable proxy for assessing corporate governance practices in Korean firms.

Prognostic analysis of cT1-3N1M0 breast cancer patients who have responded to neoadjuvant therapy undergoing various axillary surgery and breast surgery based on propensity score matching and competitive risk model.

Sentinel lymph node biopsy (SLNB) in breast cancer patients with positive clinical axillary lymph nodes (cN1+) remains a topic of controversy. The aim of this study is to assess the influence of various axillary and breast surgery approaches on the survival of cN1+ breast cancer patients who have responded positively to neoadjuvant therapy (NAT). Patients diagnosed with pathologically confirmed invasive ductal carcinoma of breast between 2010 and 2020 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. To mitigate confounding bias, propensity score matching (PSM) analysis was employed. Prognostic factors for both overall survival (OS) and breast cancer-specific survival (BCSS) were evaluated through COX regression risk analysis. Survival curves were generated using the Kaplan-Meier method. Furthermore, cumulative incidence and independent prognostic factors were assessed using a competing risk model. The PSM analysis matched 4,890 patients. Overall survival (OS) and BCSS were slightly worse in the axillary lymph node dissection (ALND) group (HR = 1.10, 95% CI 0.91-1.31, p = 0.322 vs. HR = 1.06, 95% CI 0.87-1.29, p = 0.545). The mastectomy (MAST) group exhibited significantly worse OS and BCSS outcomes (HR = 1.25, 95% CI 1.04-1.50, p = 0.018 vs. HR = 1.37, 95% CI 1.12-1.68, p = 0.002). The combination of different axillary and breast surgery did not significantly affect OS (p = 0.083) but did have a significant impact on BCSS (p = 0.019). Competing risk model analysis revealed no significant difference in the cumulative incidence of breast cancer-specific death (BCSD) in the axillary surgery group (Grey's test, p = 0.232), but it showed a higher cumulative incidence of BCSD in the MAST group (Grey's test, p = 0.001). Multivariate analysis demonstrated that age ≥ 70 years, black race, T3 stage, ER-negative expression, HER2-negative expression, and MAST were independent prognostic risk factors for both OS and BCSS (all p < 0.05). For cN1+ breast cancer patients who respond positive to NAT, the optimal surgical approach is combining breast-conserving surgery (BCS) with SLNB. This procedure improves quality of life and long-term survival outcomes.

Does land transfer help alleviate relative poverty in China? An analysis based on income and capability perspective

ABSTRACT By the end of 2020, China had achieved the goal of eradicating absolute poverty and entered an essential stage of consolidating the achievements of poverty alleviation and promoting rural revitalization. In the future, poverty governance will shift towards relative poverty. Based on the China Family Panel Studies (CFPS) database and the propensity score matching model, this paper empirically analyses the alleviating effect of land transfer on relative poverty among rural households. The results show that land transfer can effectively alleviate the multidimensional relative poverty of rural households, and the effect of transferring out land is greater than that of transferring in land. In the future, to improve the land transfer system and promote rural revitalization, it is necessary to actively establish a long-term financial poverty alleviation system in rural areas to ensure a stable income for households that transfer in land, strengthen the construction and regulation of the land transfer market, and further improve the rural social security system to provide comprehensive social security for migrant workers who move to cities and agricultural operators who stay in rural areas.

The Impact of Land Transfer-In on Crop Planting Structure and Its Heterogeneity among Farmers: Evidence from China

The crop planting structure in the world has shown a trend of “non-grain”, which will shake the foundations of global food security in the long run. As a basic and important production factor, changes in land will have an impact on farmers’ crop planting decisions. In this paper, we take China, a country that is experiencing land transfer, “non-grain” production, and farmer differentiation, as the research area, use the household survey data at the national level, and adopt the methods of Propensity Score Matching (PSM) and multiple regression models to reveal the impact of land transfer-in on the crop planting structure and its heterogeneity among farmers. The results showed that land transfer-in can drive the crop planting structure to tend to be “non-grain” in China. The research conclusion was still valid after the robustness tests of expanding the sample size, increasing the number of control variables, and introducing endogenous problem management. The heterogeneity analysis indicated that the negative impact of land transfer-in on the planting of grain crops mainly exists for large-scale farmers and farmers with agriculture as the main source of income. Based on these findings, the Chinese government should formulate targeted policies to prevent the “non-grain” tendency of crop planting structure after land transfer-in.

Prognostic value of baseline neutrophil/lymphocyte ratio in HER2-positive metastatic breast cancer: exploratory analysis of data from the CLEOPATRA trial

PurposeThis study aimed to evaluate the prognostic role of the baseline neutrophil/lymphocyte ratio (NLR) in HER2-positive metastatic breast cancer (MBC) patients treated with trastuzumab/pertuzumab.Experimental designData from 780 patients from the CLEOPATRA trial and 248 local patients were collected. Patients were divided into the low and high NLR subgroups by the NLR cutoff value. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) methods were used to control bias. Associations between the NLR and progression-free survival (PFS) and overall survival (OS) were analyzed.ResultsThe baseline characteristics of the subgroups were well balanced after PSM and IPTW. A low baseline NLR was associated with better PFS and OS in the trastuzumab and docetaxel (TH) group in the unadjusted, PSM and IPTW models. After IPTW, a low NLR, versus a high NLR, was associated with improved PFS (HR 1.35, 95% CI 1.07–1.70, P = 0.012) and OS (HR 1.47, 95% CI 1.12–1.94, P = 0.006) in the TH group. In patients undergoing treatment with trastuzumab and pertuzumab and docetaxel (THP), a low baseline NLR was also correlated with better PFS but not OS across the three models. After IPTW, a low NLR was associated with better PFS (HR 1.52, 95% CI 1.20–1.93, P = 0.001) than a high NLR in the THP group. Multivariate analyses showed that a low baseline NLR was a predictor for PFS and OS in the TH group and for PFS in the THP group in all three models. In the real-world setting, a low baseline NLR was a predictor of better PFS among patients treated with docetaxel plus trastuzumab without or with pertuzumab in the multivariate model (P = 0.015 and 0.008, respectively).ConclusionsA low baseline NLR is associated with better survival outcomes among HER2-positive MBC patients receiving docetaxel plus trastuzumab/pertuzumab as first-line therapy.

Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort.

In Italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. The aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. A database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. The primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. The results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. A total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). Group A versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51-0.70; P < 0.001). A mean postoperative duration of stay difference of 0.86 days was detected between groups. No difference was recorded between the two groups for all the other endpoints. This study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery.

Thoracoabdominal Esophagectomy: Then and Now

BackgroundOpen approaches for esophagectomy are often still useful; of these, left thoracoabdominal esophagectomy (TAE) is poorly understood and often criticized. Hence, we examined TAE’s worldwide utilization, survival, and present-day use and outcomes at our institution compared with contemporary national averages. MethodsThe Worldwide Esophageal Cancer Collaboration database includes 8854 patients who underwent esophagectomy for cancer between 2005 and 2014, a period when TAE was our center’s most common approach. Two propensity score–matched models were constructed: worldwide TAE vs worldwide non-TAE (751 matched pairs); and our high-volume center TAE vs worldwide non-TAE (273 matched pairs). All-cause mortality was compared between matched groups. Institutional TAE data from 2017 to 2021 were assessed for present-day use and outcomes. ResultsWorldwide, propensity score–matched patients undergoing TAE had a median of 20 lymph nodes resected vs 17 after non-TAE (P < .0001). Five-year survival was 34% for worldwide TAE vs 42% for worldwide non-TAE groups (P = .04). Three-year matched survival was 52% for high-volume TAE compared with 54% for worldwide non-TAE groups (P = .1). From 2017 to 2021 at our institution, 90 (26%) of 346 esophagectomies were performed by TAE. Pneumonia developed in 5 patients (5.6%), with 88 patients (98%) alive at 30 days, comparable to contemporary averages of The Society of Thoracic Surgeons. ConclusionsWhen it is performed as the primary approach in high volumes, TAE can have comparable outcomes to non-TAE with low morbidity. At present, we find that TAE is most useful in patients with truncal obesity, prior abdominal operations, and locally advanced cardia tumors with potential for variable extent of resection.

Credit Access and Productivity of Green Small and Medium Size Enterprises in Rural Nigeria

ABSTRACT: Small and Medium size Enterprises (SMEs) have played critical roles in developing great economies over the years but are being stalled in African economies. Literature posits that the variation is largely due to limited finance for SMEs in Africa. SMEs in Nigeria have not performed credibly well over the years with its contribution to the GDP still below 5%. The consequences of climate change on agro-based firms further creates the need for credit to boost productivity. As relevant as this might be, existing empirical research seldom examined the effect of credit access on productivity of green SMEs in Nigeria. The emphasis on green SMEs is essential due to its sustainability attribute. It is on this premise that this study examines the extent to which green SMEs access credit and how it impacts on their productivity in rural Nigeria. The specific objectives are therefore: to identify the determinants of access to credit for green SMEs in rural Nigeria; and to establish to what extent access to credit affects capital, labor and total factor productivity of green SMEs in Rural Nigeria. The study employed nation-wide–General Household Survey (2016) data, for its analysis. A logit model and the propensity score matching model were used to ascertain the objectives. The justification of the propensity score model lies in the fact that it estimates an average treatment effect from observational data. The findings show that, sex, years of schooling, capital, collateral requirement, amount of loan experience and interest rate are significant determinants of credit access in rural Nigeria, while age and labor are not. Finally, the study shows that access to credit significantly affects labor productivity but does not significantly affect capital and total factor productivity. The study recommends that the conditions for credit to the agricultural sector should be revised to ensure that credits are robust enough to generate significant impacts on capital and total factor productivity. Also, green SMEs need to be prioritized in accessing credit to incentivize other farmers to do same.

Does environmental protection tax law accelerate energy transition? Evidence from electrification of 262 cities in China

While global climate risk is increasing substantially with greenhouse gas emission, energy transition is a key approach to alleviate this concern. This paper constructs the difference in difference model (DID) and the difference-in-differences based propensity score matching model (PSM-DID) to estimate the effects of China’s Environmental Protection Tax Law on energy transition and its transmission path. The empirical results show that (1) China’s Environmental Protection Tax Law can promote energy transition through electrification, and this conclusion is still valid after a series of robustness tests. (2) China’s Environmental Protection Tax Law can facilitate energy transition by improving both the quantity and the quality of industrial structure upgrading. The findings of this paper not only enrich the literature on the energy transition and environmental tax designs in developing countries but also provide an empirical reference for the government to promote energy transition orderly by implementing environmental tax.

Research on the Evaluation and Enhancement Strategies of College Students’ Health Human Capital in “Healthy Hunan” under the Background of Big Data

Abstract This paper precisely explores the structure and characteristics of college students’ healthy human capital and its influencing factors. It aims to enhance students’ positive and healthy mindset and promote optimism in life and learning. A solid analytical framework is constructed by sorting out the ordered multicategorical logistic regression model and parameter estimation methods and the application steps of the propensity score matching model. College students from ten colleges and universities in Hunan Province were selected as research subjects, and a questionnaire was designed to assess their healthy human capital. The specific factors affecting college students’ healthy human capital accumulation were analyzed in depth through the probability density analysis of propensity score matching, standard support hypothesis testing, and the parallel line test and regression results of the ordered multicategorical regression model. The findings show that the curves of the experimental and control groups after propensity score matching almost overlap in the [0.2,0.4] interval, indicating the method’s validity. A more important finding is that the number of college students with poor self-assessed physical health is 8.063 times higher than that of college students with self-assessed mental health as good, which emphasizes the significant impact of mental health on healthy human capital. Therefore, to effectively improve the health human capital of college students, students, families and universities must form a linkage mechanism and work together to cultivate college students’ health awareness.

The Determinants of Beef Cattle Market Participation on Beef Cattle Producers’ Welfare: A Case Study of West Shewa Zone, Oromia Region, Ethiopia

Due to their ability to produce meat, milk, leather, glue, gelatin, and other products that people may utilize, beef cattle are domesticated. Beef cattle production and marketing play a vital role in the growth and development of the globe and the African economy. Ethiopia has great potential for livestock population in Africa and in the world but earns less from beef cattle production and marketing. Ethiopian farmers are reluctant to beef cattle market participation. Their reluctant to participate in beef cattle marketing causes lack of beef cattle products in the market and causes high prices for beef cattle and its products. The research objective was to analyze the impact of beef cattle market participation on the welfare of beef cattle smallholder farmers in Ethiopia. The primary data come from 400 randomly selected beef cattle farmers involved in beef cattle production and marketing and actors. Descriptive statistics and inferential statistics propensity score matching (PSM) model have used to analyze the collected data. The data analysis result indicated that smallholder beef cattle farmers participating in beef cattle marketing and farmers’ annual per capita consumption expenditure (economic welfare) increased by 84% more than the nonbeef cattle market participants. We assume this is a first result and investigation in the study area. The research study is important for farmers, policymakers, researchers, and the academia in general. Providing education and training, promoting the participation of more women in beef cattle marketing, and promoting and encouraging more full-time beef cattle farmers are suggested recommendations.

Does basic medical insurance promote public health? Evidence from China family panel study.

To promote common prosperity, China government has devoted much financial resources to the basic medical insurance system, it is of great significance to improve the health level of the insured groups to prevent them from returning to poverty due to illness. Whether or not the basic medical insurance can improve health status is an important policy issue after China has win the absolute poverty alleviation movement. Based on the data of China Family Panel Studies this paper constructs a strong balanced panel data with two levels information, which including variables from family level and personal level. This paper uses the panel data fixed effect model and propensity score matching model to analysis. This paper finds that after controlling the family and personal confounding variables, the basic medical insurance has positive effect toward health status. With propensity score matching model, this paper finds that there is causality between basic medical insurance and public health. Basic medical insurance has a significant health effect, that is, basic medical insurance has a significant positive impact on individual self-rated health. Participating in basic medical insurance can significantly improve the ability of families to face risk shocks, promote the accumulation of health capital in families, promote the diversification of livelihood strategies, and effectively prevent the occurrence of returning to poverty due to illness.

Ablation for atrial fibrillation improves the outcomes in patients with heart failure with preserved ejection fraction.

Patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) have worse clinical outcomes than those with sinus rhythm (SR). We aim to investigate whether maintaining SR in patients with HFpEF through a strategy such as AF ablation would improve outcomes. This is a cohort study that analysed 1034 patients (median age 69 [63-76] years, 46.2% [478/1034] female) with HFpEF and AF. Of these, 392 patients who underwent first-time AF ablation were assigned to the ablation group, and the remaining 642 patients, who received only medical therapy, were assigned to the no ablation group. The primary endpoint was a composite of all-cause death or rehospitalization for worsening heart failure. After a median follow-up of 39 months, the cumulative incidence of the primary endpoint was significantly lower in the ablation group compared to the no ablation group (adjusted hazard ratio [HR], 0.55 [95% CI, 0.37-0.82], P = 0.003) in the propensity score-matched model. Secondary endpoint analysis showed that the benefit of AF ablation was mainly driven by a reduction in rehospitalization for worsening heart failure (adjusted HR, 0.52 [95% CI, 0.34-0.80], P = 0.003). Patients in the ablation group showed a 33% relative decrease in atrial tachycardia/AF recurrence compared to the no ablation group (adjusted HR, 0.67 [95% CI, 0.54-0.84], P < 0.001). Among patients with HFpEF and AF, the strategy of AF ablation to maintain SR was associated with a lower risk of the composite outcome of all-cause death or rehospitalization for worsening heart failure.