TY - JOUR
T1 - Changes to oral anticoagulant therapy and risk of death over a 3-year follow-up of a contemporary cohort of European patients with atrial fibrillation final report of the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) pilot general registry
AU - Boriani, G.
AU - Proietti, M.
AU - Laroche, C.
AU - Diemberger, I.
AU - Popescu, M.I.
AU - Riahi, Sam
AU - Shantsila, A.
AU - Dan, G.-A.
AU - Tavazzi, L.
AU - Maggioni, A.P.
AU - Lip, Gregory Y.H.
AU - EORP-AF General Pilot Registry Investigators
A2 - Joensen, Albert Marni
A2 - Korsgaard, Anne Marie
A2 - Sørensen, Bodil Ginnerup
A2 - Andersen , Karen Petrea
A2 - Dinesen, Pia Thisted
A2 - Venø, Stine Krogh
A2 - Riahi, Sam
PY - 2018/11/15
Y1 - 2018/11/15
N2 - Background: Contemporary European data regarding patients with atrial fibrillation (AF) allow us to assess the use of oral anticoagulants (OACs) and long-term outcomes. Methods: Patients with AF presenting to cardiologists in 9 European Society of Cardiology participating countries were enrolled and followed-up for 3-years. Results: Among the 2119 patients (40.4% female; mean age 69 ± 11 years) the prevalent types of AF at baseline were first-detected (30.5%) and paroxysmal AF (27.0%). The composite of stroke/TIA/peripheral embolism/all-cause death at 3-years occurred in 18.2%, with first detected AF and permanent AF reporting the highest event rates (22.5% and 27.3%, respectively; p < 0.0001). Age, diabetes mellitus, heart failure, restrictive cardiomyopathy, chronic kidney disease and no physical activity were significant predictors of all-cause death. Paroxysmal and persistent AF patients were more likely to be hospitalised than other types of AF (34.1% and 37.9%, p < 0.0001). At follow-up, OAC drugs were used in 80.1% of patients, with non-vitamin K antagonists (NOACs) accounting for 24.3% of patients. OAC treatment at follow-up visits changed throughout time, with a shift from VKA to NOACs reported in 5.4% of the cases, while the reverse shift (from NOACs to VKA) occurred in 8.6%. Discontinuation of OAC was recorded in while in 9.5% of visits. Conclusions: Patients outcomes at 3-years follow-up differ according to type of AF at baseline, with worse outcomes in patients presenting with first-detected or permanent AF. Changes in the type of OAC use with shifts from NOACs to VKA and vice-versa are not uncommon, as were interruptions of OAC.
AB - Background: Contemporary European data regarding patients with atrial fibrillation (AF) allow us to assess the use of oral anticoagulants (OACs) and long-term outcomes. Methods: Patients with AF presenting to cardiologists in 9 European Society of Cardiology participating countries were enrolled and followed-up for 3-years. Results: Among the 2119 patients (40.4% female; mean age 69 ± 11 years) the prevalent types of AF at baseline were first-detected (30.5%) and paroxysmal AF (27.0%). The composite of stroke/TIA/peripheral embolism/all-cause death at 3-years occurred in 18.2%, with first detected AF and permanent AF reporting the highest event rates (22.5% and 27.3%, respectively; p < 0.0001). Age, diabetes mellitus, heart failure, restrictive cardiomyopathy, chronic kidney disease and no physical activity were significant predictors of all-cause death. Paroxysmal and persistent AF patients were more likely to be hospitalised than other types of AF (34.1% and 37.9%, p < 0.0001). At follow-up, OAC drugs were used in 80.1% of patients, with non-vitamin K antagonists (NOACs) accounting for 24.3% of patients. OAC treatment at follow-up visits changed throughout time, with a shift from VKA to NOACs reported in 5.4% of the cases, while the reverse shift (from NOACs to VKA) occurred in 8.6%. Discontinuation of OAC was recorded in while in 9.5% of visits. Conclusions: Patients outcomes at 3-years follow-up differ according to type of AF at baseline, with worse outcomes in patients presenting with first-detected or permanent AF. Changes in the type of OAC use with shifts from NOACs to VKA and vice-versa are not uncommon, as were interruptions of OAC.
KW - Anticoagulants
KW - Atrial fibrillation
KW - Observational registries
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=85047217434&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2018.05.034
DO - 10.1016/j.ijcard.2018.05.034
M3 - Journal article
SN - 0167-5273
VL - 271
SP - 68
EP - 74
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -