The Research Question Heart failure (HF) and atrial fibrillation (AF) frequently coexist and are associated with many adverse outcomes HF and AF share common symptoms and both cause elevated natriuretic peptide levels, possibly impairing HF diagnosis in patients with AF We assessed the prevalence of HF in community-dwelling older high-risk patients with AF, and whether NTproBNP can efficiently be used to screen for HF

Research Design and Method We used individual patient data (IPD) from four HF screening studies in high risk community-dwelling patients in the Netherlands Definite HF diagnosis in each study was established by an expert panel following the criteria of the European Society of Cardiology We performed tow-stage IPD meta-analysis to calculate traditional diagnostic indices

What the Research Found The prevalence of HF in patients with AF was 43% Only 23% of all patients with AF had an NTproBNP level below the traditional cut-point of 125 pg/mL In these patients, still 13% had HF Sensitivity was 93%, specificity 35%, and positive and negative predictive values 51% and 86%, respectively

What this means for Clinical Practice In high-risk community-dwelling patients with AF, the prevalence of HF is high Natriuretic peptides are diagnostically not helpful when screening for HF in patients with AF Straightforward echocardiography seems to be the preferred strategy for HF screening in patients with AF