Chung S, Kim TH, Uhm JS, , et al. - Researchers examined the risk of stroke or systemic embolism (SE) and other outcomes in correlation with heart failure (HF) with preserved ejection fraction (HFpEF) vs HF with reduced ejection fraction (HFrEF) carry among patients with non-valvular atrial fibrillation (AF). Analyzing a prospective, multicenter outpatient registry with echocardiographic data of 10,589 patients from June 2016 to May 2019, they identified 935 (8.8%) patients who had HF. These comprised 43.2% patients with HFpEF and 56.8% patients with HFrEF. The HFpEF group vs no-HF group had a significantly higher cumulative incidence of stroke/SE and risk of stroke/SE. Compared with the no-HF group, the HFpEF group consistently exhibited an increased risk of stroke/SE even in patients on oral anticoagulation therapy. Larger left atrial size but not reduced left ventricular ejection fraction was correlated with the risk of stroke/SE. Results thereby indicate the possible value of strict oral anticoagulation therapy in reducing the risk of stroke/SE in patients with non-valvular AF and HFpEF, particularly in those with a larger left atrial size.