Abstract 15242: Increased Mortality Among African American Patients With Heart Failure Caused by Hereditary Transthyretin Amyloid Cardiomyopathy

Introduction: Hereditary transthyretin amyloid cardiomyopathy (pV142I hATTR-CM) is an under-recognized cause of heart failure (HF) in elderly patients of African origin. While we have previously demonstrated that the endogenous TTR ligand retinol binding protein 4 (RBP4) identifies patients with hATTR-CM, its capacity to predict outcomes is unexplored. Further, comparative data are lacking describing clinical outcomes in hATTR-CM vs. matched patients with HF. Hypothesis: Reduced survival is associated with pV142I hATTR-CM when compared to an age, race, sex matched patients with HF. Methods: Retrospective, single center, cohort study of self-reported African American patients ≥ 60 years of age with normal TTR genotype, HF, and LV wall thickness ≥ 12mm (n=84) were compared to a cohort with biopsy-proven pV142I hATTR-CM (n=30). Patients did not receive ATTR-specific therapies, as study occurred prior to FDA approvals. Baseline laboratory values were measured. All-cause mortality was estimated and compared between groups based on a median followup of 45.4 months. Analyses were conducted with Fisher Exact, Kruskal Wallis, and Kaplan-Meier with log-rank testing. Results: hATTR-CM patients were slightly older but less likely to have concomitant HTN or DM (Table 1). Baseline RBP4 concentration was lower while troponin level higher in patients with hATTR-CM (Table 1). hATTR-CM patients had a higher hazard of all-cause mortality after adjusting for age (HR=3.5, 95% CI: 1.8 – 6.7, p<0.001). Baseline RBP4 was not a significant predictor of mortality (p-value=0.195). Conclusions: Patients pV142I hATTR-CM demonstrate significantly reduced survival (a 3.5-fold increased risk of death, 43% 4-year survival) compared to control subjects with HF in the absence of amyloidosis. Baseline RBP4 concentration did not associate with survival. These data suggest that hATTR-CM recognition is essential to permit implementation of available therapies that can improve survival.

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Abstract 12936: Impact of Mitral Regurgitation on Heart Failure Hospitalization and Mortality in Older Age Adults With a Preserved Ejection Fraction

Circulation ◽

10.1161/circ.142.suppl_3.12936 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Ginger Y Jiang ◽

Warren J Manning ◽

Lawrence Markson ◽

A. R Garan ◽

Marwa A Sabe ◽

...

Keyword(s):

Heart Failure ◽

Mitral Regurgitation ◽

Ejection Fraction ◽

Primary Outcome ◽

Secondary Outcome ◽

P Value ◽

Preserved Ejection Fraction ◽

Risk Of Death ◽

Increased Risk ◽

All Cause Mortality

Background: The effect of mitral regurgitation (MR) severity on heart failure (HF) hospitalization and mortality in individuals with a preserved ejection fraction (LVEF) and no prior HF history is uncertain. Methods: Transthoracic echocardiogram (TTE) reports from patients with an LVEF > 50% at our institution were linked to complete Medicare inpatient claims, 2003-2017. Patients with HF hospitalization within the 12 months prior to TTE were excluded. We evaluated the relationship of baseline MR severity and time to the composite of all-cause mortality or HF hospitalization using the Kaplan-Meier technique. Secondary outcomes included the individual components of all-cause mortality and HF hospitalization, adjusting for the competing risk of death with Fine-Gray methods. Results: A total of 18,315 individuals met inclusion criteria (77.6 ±7.7 years, 54.3% female). Over a median follow-up time of 6.5 (IQR 3.0 to 10.2) years, the primary endpoint occurred in 7566 individuals (50.6%) of whom 6,927 (37.8%) died and 1703 (13.9%) were admitted for HF at a median of 1.4 (IQR 0.2 to 4.3) years and 1.6 (IQR 0.2 to 4.3) years respectively ( Figure ). After multivariable adjustment, MR severity was not associated with the primary or secondary outcome at 1-, 3-, 5-, or 10-years after TTE (p > 0.05 for all). Mitral valve prolapse (MVP) was associated with decreased risk of the primary outcome at 1-year and 3-years (interaction p-value = 0.04 for both). Jet eccentricity did not impact the observed relationship (interaction p-value > 0.05). Conclusions: In this large, single institution echocardiographic study of individuals with preserved ejection fraction and no prior history of HF, MR severity was not associated with an increased risk of all-cause mortality or HF hospitalization. Presence of MVP was associated with decreased risk of the primary outcome with increasing MR severity.

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Abstract 16128: Association Between Timing of Readmission and Risk of 1-year Mortality Among Patients After Hospitalization for Heart Failure in China: Findings From the China-PEACE Prospective Heart Failure Study

Circulation ◽

10.1161/circ.142.suppl_3.16128 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

YILAN Ge ◽

Bin Wang ◽

jing li ◽

xin zheng

Keyword(s):

Heart Failure ◽

Patient Characteristics ◽

National Sample ◽

Cox Models ◽

Quality Metric ◽

Risk Of Death ◽

Kaplan Meier ◽

Increased Risk ◽

All Cause Mortality ◽

Early Readmission

Introduction: Although 30-day readmission has been used as a quality metric for treatment of patients hospitalized for heart failure (HF), the association between the timing of readmission with mortality after discharge has been scarcely investigated. Methods: We studied a national sample of 4875 patients admitted to 52 hospitals for HF between 2016 and 2018 who were discharged alive from the China PEACE-Heart Failure Study. The timing of readmission was defined as the timing of first readmission from all cause after discharge. Mortality analyses across the timing of readmission were performed using Kaplan-Meier curves and log-rank tests. The associations between the timing of readmission and 1-year all-cause mortality was determined using Cox models. Results: The median participant age was 67 (57-76) years, and 37.5% were female. The median duration from discharge to readmission was 88 (28-194) days. Kaplan-Meier analysis revealed 1-year mortality did not differ between patients admitted within 0-30 and 31-60 days, and between patients admitted within 61-90 and 91-180 days after discharge (Figure1A). Then we classified the timing of readmission as early (0-60 days), midrange (61-180 days) and late (181-365 days). The 1-year all-cause mortality for patients experiencing early, midrange and late readmission was 31.8%, 23.2% and 12.0%, respectively (Figure1B). After adjusting for patient characteristics and treatment during hospitalization, the HR for 1-year all-cause mortality was 2.89 (95% CI 2.22-3.77) for patients with early readmission, and 2.07 (95% CI 1.56-2.75) for patients with midrange readmission when compared with patients with late readmission, respectively. Conclusions: Earlier readmission are associated with increased risk for 1-year all-cause mortality. Not only 30-day readmission but also readmission within 60 days after discharge could be perceived as an alarming sign of higher risk of death in patients with hospitalized HF in China.

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Association of Retinol-Binding Protein 4 with Arteriovenous Fistula Dysfunction in Hemodialysis Patients

Blood Purification ◽

10.1159/000513418 ◽

2021 ◽

pp. 1-8

Author(s):

Yuanhao Wu ◽

Fan Wang ◽

Tingting Wang ◽

Yin Zheng ◽

Li You ◽

...

Keyword(s):

Risk Factor ◽

Arteriovenous Fistula ◽

Independent Risk Factor ◽

Binding Protein ◽

Retinol Binding Protein ◽

Youden Index ◽

Serum Concentrations ◽

Retinol Binding Protein 4 ◽

Kaplan Meier ◽

Increased Risk

Background: Arteriovenous fistula (AVF) is the most common vascular access for patients undergoing hemodialysis (HD). Neointimal hyperplasia (NIH) might be a potential mechanism of AVF dysfunction. Retinol-binding protein 4 (RBP4) may play an important role in the pathogenesis of NIH. The aim of this study was to investigate whether AVF dysfunction is associated with serum concentrations of RBP4 in HD subjects. Methods: A cohort of 65 Chinese patients undergoing maintenance HD was recruited between November 2017 and June 2019. The serum concentrations of RBP4 of each patient were measured with the ELISA method. Multivariate logistic regression was used to analyze data on demographics, biochemical parameters, and serum RBP4 level to predict AVF dysfunction events. The cutoff for serum RBP4 level was derived from the highest score obtained on the Youden index. Survival data were analyzed with the Cox proportional hazards regression analysis and Kaplan-Meier method. Results: Higher serum RBP4 level was observed in patients with AVF dysfunction compared to those without AVF dysfunction events (174.3 vs. 168.4 mg/L, p = 0.001). The prevalence of AVF dysfunction events was greatly higher among the high RBP4 group (37.5 vs. 4.88%, p = 0.001). In univariate analysis, serum RBP4 level was statistically significantly associated with the risk of AVF dysfunction (OR = 1.015, 95% CI 1.002–1.030, p = 0.030). In multivariate analysis, each 1.0 mg/L increase in RBP4 level was associated with a 1.023-fold-increased risk of AVF dysfunction (95% CI for OR: 1.002–1.045; p = 0.032). The Kaplan-Meier survival analysis indicated that the incidence of AVF dysfunction events in the high RBP4 group was significantly higher than that in the low-RBP4 group (p = 0.0007). Multivariate Cox regressions demonstrated that RBP4 was an independent risk factor for AVF dysfunction events in HD patients (HR = 1.015, 95% CI 1.001–1.028, p = 0.033). Conclusions: HD patients with higher serum RBP4 concentrations had a relevant higher incidence of arteriovenous dysfunction events. Serum RBP4 level was an independent risk factor for AVF dysfunction events in HD patients.

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D-dimer and the incidence of heart failure and mortality after acute myocardial infarction

Heart ◽

10.1136/heartjnl-2020-316880 ◽

2020 ◽

pp. heartjnl-2020-316880 ◽

Cited By ~ 1

Author(s):

Xiaoyuan Zhang ◽

Shanjie Wang ◽

Jinxin Liu ◽

Yini Wang ◽

Hengxuan Cai ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Acute Myocardial Infarction ◽

Plaque Rupture ◽

Risk Of Death ◽

Increased Risk ◽

Clinical Covariates ◽

All Cause Mortality ◽

D Dimer

ObjectiveD-dimer might serve as a marker of thrombogenesis and a hypercoagulable state following plaque rupture. Few studies explore the association between baseline D-dimer levels and the incidence of heart failure (HF), all-cause mortality in an acute myocardial infarction (AMI) population. We aimed to explore this association.MethodsWe enrolled 4504 consecutive patients with AMI with complete data in a prospective cohort study and explored the association of plasma D-dimer levels on admission and the incidence of HF, all-cause mortality.ResultsOver a median follow-up of 1 year, 1112 (24.7%) patients developed in-hospital HF, 542 (16.7%) patients developed HF after hospitalisation and 233 (7.1%) patients died. After full adjustments for other relevant clinical covariates, patients with D-dimer values in quartile 3 (Q3) had 1.51 times (95% CI 1.12 to 2.04) and in Q4 had 1.49 times (95% CI 1.09 to 2.04) as high as the risk of HF after hospitalisation compared with patients in Q1. Patients with D-dimer values in Q4 had more than a twofold (HR 2.34; 95% CI 1.33 to 4.13) increased risk of death compared with patients in Q1 (p<0.001). But there was no association between D-dimer levels and in-hospital HF in the adjusted models.ConclusionsD-dimer was found to be associated with the incidence of HF after hospitalisation and all-cause mortality in patients with AMI.

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Platelet-to-hemoglobin ratio as a valuable predictor of long-term all-cause mortality in coronary artery disease patients with congestive heart failure

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02423-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kunming Bao ◽

Haozhang Huang ◽

Guoyong Huang ◽

Junjie Wang ◽

Ying Liao ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Congestive Heart Failure ◽

Coronary Artery ◽

Prognostic Biomarker ◽

Kaplan Meier ◽

Increased Risk ◽

All Cause Mortality ◽

Artery Disease

Abstract Background The platelet-to-hemoglobin ratio (PHR) has emerged as a prognostic biomarker in coronary artery disease (CAD) patients after PCI but not clear in CAD complicated with congestive heart failure (CHF). Hence, we aimed to assess the association between PHR and long-term all-cause mortality among CAD patients with CHF. Methods Based on the registry at Guangdong Provincial People’s Hospital in China, we analyzed data of 2599 hospitalized patients who underwent coronary angiography (CAG) and were diagnosed with CAD complicated by CHF from January 2007 to December 2018. Low PHR was defined as ˂ 1.69 (group 1) and high PHR as ≥ 1.69 (group 2). Prognosis analysis was performed using Kaplan–Meier method. To assess the association between PHR and long-term all-cause mortality, a Cox-regression model was fitted. Results During a median follow-up of 5.2 (3.1–7.8) years, a total of 985 (37.9%) patients died. On the Kaplan–Meier analysis, patients in high PHR group had a worse prognosis than those in low PHR group (log-rank, p = 0.0011). After adjustment for confounders, high PHR was correlated with an increased risk of long-term all-cause mortality in CAD patients complicated with CHF. (adjusted hazard ratio [aHR], 1.31; 95% confidence interval [CI], 1.13–1.52, p < 0.0001). Conclusion Elevated PHR is correlated with an increased risk of long-term all-cause mortality in CAD patients with CHF. These results indicate that PHR may be a useful prognostic biomarker for this population. Meanwhile, it is necessary to take effective preventive measures to regulate both hemoglobin levels and platelet counts in this population.

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Association of Systemic Inflammation and Malnutrition With Survival in Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy: Results From a Multicenter Cohort Study

Frontiers in Oncology ◽

10.3389/fonc.2021.766398 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xin Wang ◽

Ming Yang ◽

Yizhong Ge ◽

Meng Tang ◽

Benqiang Rao ◽

...

Keyword(s):

Cohort Study ◽

Nasopharyngeal Carcinoma ◽

Systemic Inflammation ◽

Multicenter Cohort Study ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Multicenter Cohort ◽

Kaplan Meier ◽

Increased Risk ◽

All Cause Mortality

BackgroundMalnutrition and systemic inflammation are common in patients with nasopharyngeal carcinoma (NPC). The Patient-Generated Subjective Global Assessment (PG-SGA) score and neutrophil-to-lymphocyte ratio (NLR) reflect the integrated nutritional status and inflammatory level of patients with NPC, respectively. We performed this study to identify whether NLR and PG-SGA score are associated with outcome and survival time for patients with NPC undergoing chemoradiotherapy.MethodsThe multicenter cohort study included 1,102 patients with NPC between June 2012 and December 2019. The associations of all-cause mortality with NLR and PG-SGA score were calculated using the Kaplan–Meier method and the log-rank test. We also did a multivariate-adjusted Cox regression analysis to identify the independent significance of different parameters. Restricted cubic spline regression was carried out to evaluate the association between NLR and overall survival (OS). A nomogram was established using the independent prognostic variables. Interaction terms were used to investigate whether there was an interactive association between NLR and PG-SGA.ResultsA total of 923 patients with NPC undergoing chemoradiotherapy were included in this study: 672 (72.8%) were males and 251 (27.2%) were females, with a mean age of 49.3 ± 11.5 years. The Kaplan–Meier curves revealed that patients with malnutrition (PG-SGA score >3) had worse survival than patients who were in the well-nourished group (PG-SGA score ≤3) (p < 0.0001). In addition, patients in the high NLR group (NLR ≥ 3) had worse survival than those in the low NLR group (NLR < 3) (p < 0.0001). Patients with high PG-SGA and high NLR had the worst survival (p < 0.0001). An increase in NLR had an inverted L-shaped dose–response association with all-cause mortality. A nomogram was developed by incorporating domains of NLR and PG-SGA score to accurately predict OS 12–60 months for patients [the C-index for OS prediction of nomogram was 0.75 (95% CI, 0.70–0.80)]. The interaction of PG-SGA with NLR was significant (p = 0.009). Patients with high PG-SGA and high NLR had a nearly 4.5-fold increased risk of death (HR = 4.43, 95% CI = 2.60–7.56) as compared with patients with low PG-SGA and low NLR.ConclusionsOur study provided clear evidence that high PG-SGA score and high NLR adversely and interactively affects the OS of patients with NPC undergoing chemoradiotherapy.

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Digoxin and association with mortality in patients discharged from hospital with atrial fibrillation, with or without heart failure

EP Europace ◽

10.1093/europace/euab116.183 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

M Mpotis ◽

A Kartas ◽

A Samaras ◽

E Akrivos ◽

E Vrana ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Propensity Scores ◽

Adverse Outcomes ◽

Secondary Outcome ◽

Event Analysis ◽

Risk Of Death ◽

Funding Sources ◽

Increased Risk ◽

All Cause Mortality

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf MISOAC- AF study group BACKGROUND Digoxin is widely used in atrial fibrillation (AF) and heart failure (AF). However, established evidence is conflicting regarding its association with clinical outcomes. AIM To investigate the relation between digoxin and adverse outcomes in patients with AF, with or without HF, in a contemporary AF cohort. METHODS We performed a retrospective analysis of data from 698 patients, originating from the MISOAC- AF (Motivational Interviewing to Support Oral AntiCoagulation Adherence in patients with non-valvular Atrial Fibrillation) trial, and followed over a median of 2.5 years. HF was denoted at baseline. The primary outcome was all-cause mortality and the secondary outcome was all-cause hospitalization, in a time-to-event analysis. Propensity scores were used to derive matched populations, balanced on key baseline covariates. To limit potential confounding, we also implemented inverse probability of treatment weighting (IPTW) analysis. RESULTS Among patients with HF, 10.5% (n = 39) were administered digoxin at baseline, whereas 89.5% (n = 331) were not. Digoxin administration was not associated with an increased risk of death (hazard ratio (HR) in the digoxin group, 1.21; 95% Confidence Interval (CI), 0.69 to 2.13, p = 0.5) or hospitalization of any cause (HR 1.15; 95% CI, 0.67 to 1.96; p = 0.6). Among patients without HF, 3.5% (n = 11) were administered digoxin, with neutral effects on all-cause mortality (HR: 3.25; 95% CI, 0.98 to 10.70), p = 0.06) and all-cause hospitalization (HR, 1.15; 95% CI, 0.67 to 1.96, p = 0.60). Consistent qualitatively results were observed using IPTW. CONCLUSIONS Among patients with AF, digoxin administration was not associated with an increased risk of death and hospitalization of any cause, irrespective of HF status. Abstract Figure.

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Platelet-to-hemoglobin ratio as a valuable predictor of long-term all-Cause mortality in coronary artery disease patients with congestive heart failure

10.21203/rs.3.rs-668943/v1 ◽

2021 ◽

Author(s):

Kunming Bao ◽

Haozhang Huang ◽

Guoyong Huang ◽

Junjie Wang ◽

Ying Liao ◽

...

Keyword(s):

Heart Failure ◽

Coronary Artery Disease ◽

Congestive Heart Failure ◽

Coronary Artery ◽

Prognostic Biomarker ◽

Kaplan Meier ◽

Increased Risk ◽

All Cause Mortality ◽

Artery Disease

Abstract Background The platelet-to-hemoglobin ratio (PHR) has emerged as a prognostic biomarker in coronary artery disease (CAD) patients after PCI but not clear in CAD complicated with congestive heart failure (CHF). Hence, we aimed to assess the association between PHR and long-term all-cause mortality among CAD patients with CHF. Methods Based on the registry at Guangdong Provincial People’s Hospital in China, we analyzed data of 2,599 hospitalized patients who underwent coronary angiography (CAG) and were diagnosed with CAD complicated by CHF from January 2007 to December 2018. Low PHR was defined as˂1.69 (group 1) and high PHR as ≥ 1.69 (group 2). Prognosis analysis was performed using Kaplan-Meier methods. To assess the association between PHR and long-term all-cause mortality, a Cox-regression model was fitted. Results During a median follow-up of 5.2 (3.1–7.8) years, a total of 985 (37.9%) patients died. On the Kaplan-Meier analysis, patients in high PHR group had a worse prognosis than low PHR group (log-rank, p = 0.0011). After adjustment for confounders, high PHR was correlated with an increased risk of long-term all-cause mortality in CAD patients complicated with CHF. (adjusted hazard ratio [aHR], 1.21; 95% confidence interval [CI], 1.03–1.41, p = 0.02). Conclusion Elevated PHR is correlated with an increased risk of long-term all-cause mortality in CAD patients with CHF. These results indicate that PHR may be a useful prognostic biomarker for this population. Meanwhile, it is necessary to take effective preventive measures to regulate both hemoglobin levels and platelet counts in this population.

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Abstract 16397: Presence of Myocardial Injury on Admission is Associated With an Increase in All-cause Mortality in Patients With COVID-19

Circulation ◽

10.1161/circ.142.suppl_3.16397 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Zain Ahmed ◽

Avinainder Singh ◽

Lina Vadlamani ◽

Maxwell Eder ◽

Zaniar Ghazizadeh ◽

...

Keyword(s):

Myocardial Injury ◽

Academic Medical Center ◽

Cardiac Biomarkers ◽

P Value ◽

Early Management ◽

Health Crisis ◽

Risk Of Death ◽

Ctnt Level ◽

Increased Risk ◽

All Cause Mortality

Introduction: COVID-19 has emerged as a global health crisis resulting in nearly half a million deaths worldwide to date. Patients with COVID-19 experience significant cardiovascular manifestations including myocardial injury. We sought to determine the risk of myocardial injury within 24 hours of admission on all-cause mortality in patients with COVID-19. Methods: This was a prospective cohort study of patients hospitalized with COVID-19 at a major academic medical center between March 1, 2020-June 1, 2020. The combination of cardiac troponin T (cTnT) elevation (defined as ≥0.01 ng/mL) within 24 hours of admission and an elevated NT-proBNP (defined as >450.0 pg/mL) on admission were used as biomarker surrogates for myocardial injury. Results: There were n = 415 consecutive patients who were hospitalized with COVID-19 with a median age of 68.5 years (IQR 58-81), 44.8% were women, a median BMI of 28.8 (IQR 24.6-35.6), 5.8% of patients had end-stage renal disease on dialysis, 21.6% had a prior diagnosis of coronary artery disease and 21.8% had a prior diagnosis of congestive heart failure. Among patients with at least one positive cTnT level within 24 hours of admission, the median cTnT level was 0.04 ng/mL (IQR 0.01-0.77 ng/mL). Among those with elevated BNP, the median BNP was 1930 pg/mL (IQR 799-5826 pg/mL) on admission. Patients with COVID-19 who had an elevation in both cardiac biomarkers on admission had higher all-cause mortality than patients with COVID-19 who had negative biomarkers (38.2% vs. 7.5%, respectively, p-value < 0.001), with nearly a 5-fold increase in mortality when adjusted for age, gender, BMI and renal dysfunction (adjusted OR 4.9, p-value: 0.003, 95% CI 1.7-13.9, See Figure) Conclusion: Myocardial injury is common in patients with COVID-19 and is associated with a significantly increased risk of death. Cardiac biomarkers on admission can serve as prognostic factors and may guide early management of COVID-19.

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Stroke risk scores to predict hospitalization for acute decompensated heart failure in atrial fibrillation patients

Romanian Journal of Internal Medicine ◽

10.2478/rjim-2020-0032 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Andreea Cristina Ivănescu ◽

Gheorghe-Andrei Dan

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Stroke Risk ◽

Predictive Accuracy ◽

Acute Decompensated Heart Failure ◽

University Hospital ◽

Risk Scores ◽

P Value ◽

Risk Of Death ◽

Increased Risk

AbstractIntroduction: Atrial fibrillation (AF) is the most frequent hospitalized arrhythmia. It associates increased risk of death, stroke and heart failure (HF). Stroke risk scores, especially CHA2DS2-VASc, have been applied also for populations with different diseases. There is, however, limited data focusing on the ability of these scores to predict HF decompensation.Methods: We conducted a retrospective observational study on a cohort of 204 patients admitted for cardiovascular pathology to the Cardiology Ward of our tertiary University Hospital. We aimed to determine whether the stroke risk scores could predict hospitalisations for acute decompensated HF in AF patients.Results: C-statistics for CHADS2 and R2CHADS2 showed a modest predictive ability for hospitalisation with decompensated HF (CHADS2: AUC 0.631 p=0.003; 95%CI 0.560-0.697. R2CHADS2: AUC 0.619; 95%CI 0.548-0.686; p=0.004), a marginal correlation for CHA2DS2-VASc (AUC 0.572 95%CI 0.501-0.641 with a p value of only 0.09, while the other scores failed to show a correlation. A CHADS2≥2 showed a RR=2.96, p<0.0001 for decompensated HF compared to a score <2. For R2CHADS2 ≥2, RR= 2.41, p=0.001 compared to a score <2. For CHA2DS2-VASc≥2 RR=2.18 p=0.1, compared to CHA2DS2-VASc <2. The correlation coefficients showed a weak correlation for CHADS2 (r=0.216; p=0.001) and even weaker for R2CHADS2 (r=0.197; p=0.0047 and CHA2DS2-VASc (r=0.14; p=0.035).Conclusions: Among AF patients, CHADS2, CHA2DS2-VASc and R2CHADS2 were associated with the risk of hospitalisation for decompensated HF while ABC and ATRIA failed to show an association. However, predictive accuracy was modest and the clinical utility for this outcome remains to be determined.

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