Vascular disease in patients with atrial fibrillation. A report from Polish participants in the EORP-AF General Long-Term Registry.


Journal

International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381

Informations de publication

Date de publication:
Mar 2021
Historique:
revised: 06 08 2020
received: 27 02 2020
accepted: 02 09 2020
pubmed: 12 9 2020
medline: 12 5 2021
entrez: 11 9 2020
Statut: ppublish

Résumé

This study aimed to (1) define the prevalence of vascular disease (VD; coronary (CAD) and/or peripheral artery disease (PAD)) and associated risk factors in patients with atrial fibrillation (AF); (2) establish the relationship of VD and associated treatment patterns on adverse events in AF. Data from 701 Polish AF patients enrolled in the EORP-AF General Long-Term Registry in the years 2013-2016 were included in this analysis. During the one-year follow-up, the occurrence of major adverse events (MAE; all-cause death, thromboembolic event, myocardial infraction) and its components was evaluated. VD was recorded in 293 (44%) patients and based on multivariate logistic analysis was associated with age >75, diabetes, hypercholesterolemia, heart failure (HF). There was no significant difference in rates of MAE between patients with and without VD based on Fisher's exact test (8.8% vs 5.7%, P = .16), as well as between patients with concomitant CAD and PAD, PAD and CAD alone based on the Chi-square test (21% vs 7.5% vs 6.7%; P = .09). A higher risk of MAE was associated with HF, chronic kidney disease (in all study group), age >75, HF, diabetes (VD group),chronic obstructive pulmonary disease (non-VD group) based on the multivariate logistic analysis. Relative to patients with VD on vitamin K antagonists (VKA), those treated with non-VKA-oral anticoagulants (NOAC) had lower absolute rate of MAE according to Fisher's exact test (1.4% vs 10%, P = .02) but similar risks for thromboembolic and hemorrhagic events. The concomitant use of triple therapy was associated with increased risk of MAE as compared with those on OAC alone or dual therapy based on the Chi-square test (20% vs 4.8%, 3.2%, P = .02). VD was prevalent in almost two-fifths of AF patients. The incidence of MAE was higher in patients with VD on VKA (vs NOAC) and on triple therapy (vs dual therapy, OAC alone) within one-year follow-up.

Identifiants

pubmed: 32915461
doi: 10.1111/ijcp.13701
doi:

Substances chimiques

Anticoagulants 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13701

Informations de copyright

© 2020 John Wiley & Sons Ltd.

Références

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Auteurs

Monika Gawałko (M)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Piotr Lodziński (P)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Monika Budnik (M)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Agata Tymińska (A)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Anna Wancerz (A)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Krzysztof Ozierański (K)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Agnieszka Kapłon-Cieślicka (A)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Marcin Grabowski (M)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Grzegorz Opolski (G)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Radosław Lenarczyk (R)

1st Department of Cardiology and Angiology, Silesian Center for Heart Disease, Zabrze, Poland.

Zbigniew Kalarus (Z)

Department of Cardiology, DMS in Zabrze, Medical University of Silesia, Katowice, Poland, Zabrze, Poland.

Gregory Y H Lip (GYH)

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Paweł Balsam (P)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

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