Abstract 13838: Life-Years Lost After Incident Atrial Fibrillation in Heart Failure

Aims: To estimate the life-years lost after newly-diagnosed atrial fibrillation (AF) in heart failure (HF) patients. Methods and Results: Among patients diagnosed with HF in 2008-2018 in the nationwide Danish Heart Failure Registry, we compared patients with incident AF (n=4,463, mean age 73.7 years, 29% women) to AF-free referents matched on age, sex, and time since HF (n=17,792). By using G-computation, we estimated the marginal hazard ratio for death (HR) and difference in restricted mean survival times (RMST) at 10 years after AF diagnosis accounting for sex, age at AF diagnosis, lifestyle factors, clinical characteristics, comorbidities, and medications. The marginal HR was 1.41 (95%CI 1.38 to 1.44). The difference in marginal RMST between HF patients with and without AF was -18.2 months (95%CI -16.8 to -19.6) at 10 years after AF diagnosis. Subgroup analyses showed differences between patients diagnosed with AF >1 year and ≤1 year after HF (marginal difference in RMST at 10 years, -25.7 months, 95%CI -23.7 to -27.7, vs. -10.4 months, 95%CI -8.2 to -12.5), women and men (-20.3 months, 95%CI -17.7 to -21.9, vs. -17.2 months, 95%CI -15.5 to -19.0, p<0.001), patients ≥75 and <75 years old at AF diagnosis (-20.1 months, 95%CI -17.9 to -22.2, vs. -17.8 months, 95%CI -15.6 to -20.0, p<0.001). Conclusion: There is evidence of loss in life expectancy associated with AF in HF, with 1.5 life-years lost over 10 years after AF diagnosis. Life-years lost were significantly larger among patients diagnosed with AF >1 year after HF, women, and older patients.