Risk factors for thromboembolic and bleeding events in anticoagulated patients with atrial fibrillation: the prospective, multicentre observational PREvention oF thromboembolic events - European Registry in Atrial Fibrillation (PREFER in AF).

We identified factors associated with thromboembolic and bleeding events in two contemporary cohorts of anticoagulated patients with atrial fibrillation (AF), treated with either vitamin K antagonists (VKA) or non-VKA oral anticoagulants (NOACs). Prospective, multicentre observational study. 461 centres in seven European countries. 5310 patients receiving a VKA (PREvention oF thromboembolic events - European Registry in Atrial Fibrillation (PREFER in AF), derivation cohort) and 3156 patients receiving a NOAC (PREFER in AF Prolongation, validation cohort) for stroke prevention in AF. Risk factors for thromboembolic events (ischaemic stroke, systemic embolism) and major bleeding (gastrointestinal bleeding, intracerebral haemorrhage and other life-threatening bleeding). The mean age of patients enrolled in the PREFER in AF registry was 72±10 years, 40% were female and the mean CHA Attending to modifiable risk factors is an important treatment target in anticoagulated AF patients to reduce thromboembolic and bleeding events. Initiation of anticoagulation in those at risk of stroke should not be prevented by elevated bleeding risk scores.

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: MR received advisory fees from Daiichi Sankyo and Novarits and lecutring fees from Biotronik and Takeda Pharma. TWW received lecturing fees and advisory honoraria from Daiichi Sankyo, Boehringer Ingelheim and Pfizer/BMS. LP consultant fees from Daiichi-Sankyo, SOTIO, Beckman Coulter, Novartis. GP speaker/consultant/advisory board for Amgen, Sanofi, Bayer, Boehringer-Ingelheim, BMS-Pfizer, Daiichi Sankyo, Astra Zeneca, Sigma-Tau, Malesci, PIAM and MSD. JMSM lecture or consultant fees from AstraZeneca, Daiichi Sankyo, Eli Lilly, Bayer and research grant from Roche Diagnostics. Menarini and lecture fees from AtriCure, all outside the submitted workML is affiliated with the sponsor. KH received lecturing fees and advisory honoraria from Boehringer Ingelheim, Pfizer/BMS, Bayer, Daiichi Sankyo, Sanofi-Aventis, AstraZeneca, and Eli Lilly. RDC received research grants from Boehringer-Ingelheim, Bayer and BMS/Pfizer. Honoraria for lecturing and participation to Advisory Boards from Boehringer-Ingelheim, Bayer and BMS/Pfizer, Daiichi-Sankyo, Lilly, AstraZeneca, Merck, Novartis, Roche. PK has received research support from European Union, British Heart Foundation, Leducq Foundation, Medical Research Council (UK), and German Centre for Heart Research, from several drug and device companies active in atrial fibrillation, and has received honoraria from several such companies. PK is listed as inventor on two patents held by University of Birmingham (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783).