One-year clinical events and management of patients with atrial fibrillation hospitalized in cardiology centers: Data from the BLITZ-AF study.
Antithrombotic treatment
Atrial fibrillation
Registry
Journal
European journal of internal medicine
ISSN: 1879-0828
Titre abrégé: Eur J Intern Med
Pays: Netherlands
ID NLM: 9003220
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
23
07
2019
revised:
11
12
2019
accepted:
15
12
2019
pubmed:
19
1
2020
medline:
16
2
2021
entrez:
19
1
2020
Statut:
ppublish
Résumé
The management of atrial fibrillation (AF) has changed with the introduction of direct anticoagulants (DOACs) and new techniques such as catheter ablation. An update collection of data from "real world" AF patients followed by cardiologists is useful to obtain information on both management, outcomes and guideline adherence in clinical practice. Follow-up information on survival, embolic and bleeding events and hospital readmission, persistence of oral anticoagulant (OAC) therapy was collected in 84 centers participating to the BLITZ-AF study. Patients were followed for a median of 366 days (IQR: 356-378) and vital status was available for 2159 patients. Mortality was 9.2%. Heart failure was the most common cardiovascular cause of death (70%) followed by arrhythmias (6.7%), acute coronary syndrome (5.0%) and ischemic stroke (2.5%). During follow-up 18.1% of the patients were readmitted, mainly (81.3%) for cardiovascular causes. Patients on OAC were 83.4%, 9.1% were on antiplatelets and 7.5% did not receive antithrombotic therapy. The use of DOACs increased from 42.1% to 46.4% during the follow-up, OAC discontinuation occurred in 9.1%. AF recurrences occurred in 23.4% of the patients discharged in sinus rhythm. Rate control strategy was adopted in 55.9% and beta-blockers were the most used drugs (81.9%). Amiodarone (22%) and flecainide (9.7%) were the most frequent used antiahrrythmic drugs. The follow-up of the BLITZ-AF study provide an up to date picture of the clinical course of patients with AF, who appear frequently affected by heart failure and severe comorbidities which might have led to the high mortality rate.
Sections du résumé
BACKGROUND
The management of atrial fibrillation (AF) has changed with the introduction of direct anticoagulants (DOACs) and new techniques such as catheter ablation. An update collection of data from "real world" AF patients followed by cardiologists is useful to obtain information on both management, outcomes and guideline adherence in clinical practice.
METHODS
Follow-up information on survival, embolic and bleeding events and hospital readmission, persistence of oral anticoagulant (OAC) therapy was collected in 84 centers participating to the BLITZ-AF study.
RESULTS
Patients were followed for a median of 366 days (IQR: 356-378) and vital status was available for 2159 patients. Mortality was 9.2%. Heart failure was the most common cardiovascular cause of death (70%) followed by arrhythmias (6.7%), acute coronary syndrome (5.0%) and ischemic stroke (2.5%). During follow-up 18.1% of the patients were readmitted, mainly (81.3%) for cardiovascular causes. Patients on OAC were 83.4%, 9.1% were on antiplatelets and 7.5% did not receive antithrombotic therapy. The use of DOACs increased from 42.1% to 46.4% during the follow-up, OAC discontinuation occurred in 9.1%. AF recurrences occurred in 23.4% of the patients discharged in sinus rhythm. Rate control strategy was adopted in 55.9% and beta-blockers were the most used drugs (81.9%). Amiodarone (22%) and flecainide (9.7%) were the most frequent used antiahrrythmic drugs.
CONCLUSIONS
The follow-up of the BLITZ-AF study provide an up to date picture of the clinical course of patients with AF, who appear frequently affected by heart failure and severe comorbidities which might have led to the high mortality rate.
Identifiants
pubmed: 31952984
pii: S0953-6205(19)30435-2
doi: 10.1016/j.ejim.2019.12.006
pii:
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
55-60Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest MMG, FC, ADL and GDP have no conflict of interest to disclose. RC local expert panel for Daiichi-Sankyo. LDL reported speaker's fees from Bayer, Boehringer and Daiichi-Sankyo. GB reported speaker's fees of small amount from Bayer, Boehringer, Boston and Medtronic. DL is an employee of the Heart Care Foundation, which conducted the study with an unrestricted grant of research from Bayer, Italy. GF is a consultant of the Heart Care Foundation, which conducted the study with an unrestricted grant of research from Bayer, Italy. APM has no conflict of interest to disclose with respect to the present manuscript. Outside the present work, APM received honoraria for participation in committees of studies sponsored by Bayer, Novartis and Fresenius.