Oral anticoagulation in heart failure complicated by atrial fibrillation: A nationwide routine data study.
Atrial fibrillation
Heart failure
Mortality
Oral anticoagulation
Readmission
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 Jan 2024
15 Jan 2024
Historique:
received:
16
08
2023
revised:
03
10
2023
accepted:
08
10
2023
pubmed:
13
10
2023
medline:
13
10
2023
entrez:
12
10
2023
Statut:
ppublish
Résumé
This nationwide routine data analysis evaluates if oral anticoagulant (OAC) use in patients with heart failure (HF) and atrial fibrillation (AF) leads to a lower mortality and reduced readmission rate. Superiority of new oral anticoagulants (NOACs), compared to vitamin K antagonists (VKA), was analyzed for these endpoints. Anonymous data of patients with a health insurance at the Allgemeine Ortskrankenkasse and a claims record for hospitalization with the main diagnosis of HF and secondary diagnosis of AF (2017-2019) were included. A hospital stay in the previous year was an exclusion criterion. Mortality and readmission for all-cause and stroke/intracranial bleeding (ICB) were analyzed 91-365 days after the index hospitalization. Kaplan-Meier survival curves and multivariable Cox regression models were used to evaluate the impact of medication on outcome. 180,316 cases were included [81 years (IQR 76-86), 55.6% female, CHA Nationwide data confirm a reduction in mortality and readmission rate in HF-AF patients taking OACs, without NOAC superiority.
Sections du résumé
BACKGROUND
BACKGROUND
This nationwide routine data analysis evaluates if oral anticoagulant (OAC) use in patients with heart failure (HF) and atrial fibrillation (AF) leads to a lower mortality and reduced readmission rate. Superiority of new oral anticoagulants (NOACs), compared to vitamin K antagonists (VKA), was analyzed for these endpoints.
METHODS
METHODS
Anonymous data of patients with a health insurance at the Allgemeine Ortskrankenkasse and a claims record for hospitalization with the main diagnosis of HF and secondary diagnosis of AF (2017-2019) were included. A hospital stay in the previous year was an exclusion criterion. Mortality and readmission for all-cause and stroke/intracranial bleeding (ICB) were analyzed 91-365 days after the index hospitalization. Kaplan-Meier survival curves and multivariable Cox regression models were used to evaluate the impact of medication on outcome.
RESULTS
RESULTS
180,316 cases were included [81 years (IQR 76-86), 55.6% female, CHA
CONCLUSIONS
CONCLUSIONS
Nationwide data confirm a reduction in mortality and readmission rate in HF-AF patients taking OACs, without NOAC superiority.
Identifiants
pubmed: 37827285
pii: S0167-5273(23)01464-X
doi: 10.1016/j.ijcard.2023.131434
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
131434Informations de copyright
Copyright © 2023 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest M.M. received speakers and consulting fees from Bayer Healthcare, BMS, Boehringer Ingelheim, Daiichi Sankyo, Astra Zeneca, Sanofi, BRAHMS GmbH and Roche Diagnostics as well as research funding from German public funding authorities for Health Care Research and Roche Diagnostics; G.M. received speaker fees from Getinge, Orion Pharma and AOP Orphan Pharmaceuticals Germany GmbH; no other relationships or activities that could appear to have influenced the submitted work.