Atrial fibrillation and comorbidities: Clinical characteristics and antithrombotic treatment in GLORIA-AF

Monika Kozieł, Christine Teutsch, Jonathan L. Halperin, Kenneth J. Rothman, Hans Christoph Diener, Chang Sheng Ma, Sabrina Marler, Shihai Lu, Venkatesh K. Gurusamy, Menno V. Huisman, Gregory Y.H. Lip*, GLORIA-AF Investigators

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Background Patients with AF often have multimorbidity (the presence of ≥2 concomitant chronic conditions). Objective To describe baseline characteristics, patterns of antithrombotic therapy, and factors associated with oral anticoagulant (OAC) prescription in patients with AF and ≥2 concomitant, chronic, comorbid conditions. Methods Phase III of the GLORIA-AF Registry enrolled consecutive patients from January 2014 through December 2016 with recently diagnosed AF and CHA2DS2-VASc score ≥1 to assess the safety and effectiveness of antithrombotic treatment. Results Of 21,241 eligible patients, 15,119 (71.2%) had ≥2 concomitant, chronic, comorbid conditions. The proportions of patients with multimorbidity receiving non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKA) were 60.2% and 23.6%, respectively. The proportion with paroxysmal AF was 57.0% in the NOAC group and 45.4% in the VKA group. Multivariable log-binomial regression analysis found the following factors were associated with no OAC prescription: Pattern of AF (paroxysmal, persistent, or permanent), coronary artery disease, myocardial infarction, prior bleeding, smoking status, and region (Asia, North America, or Europe). Factors associated with OAC prescriptions were age, body mass index, renal function, hypertension, history of cerebral ischemic symptoms, and AF ablation. Conclusion Multimorbid AF patients prescribed NOACs have fewer comorbidities than those prescribed VKAs. Age, AF pattern, comorbidities, and renal function are associated with OAC prescription.

Original languageEnglish
Article numbere0249524
JournalPLOS ONE
Volume16
Issue number4
Number of pages34
ISSN1932-6203
DOIs
Publication statusPublished - 14 Apr 2021

Bibliographical note

Publisher Copyright:
© 2021 Koziel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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