TY - JOUR
T1 - Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes
T2 - real-world data from the FANTASIIA Registry
AU - García-Fernández, Amaya
AU - Esteve-Pastor, María Asunción
AU - Roldán-Rabadán, Inmaculada
AU - Muñiz, Javier
AU - Ruiz Ortiz, Martín
AU - Cequier, Ángel
AU - Bertomeu-Martínez, Vicente
AU - Badimón, Lina
AU - Otero, Déborah
AU - Anguita, Manuel
AU - Lip, Gregory Y.H.
AU - Marín, Francisco
AU - on behalf of FANTASIIA investigators
PY - 2020/9
Y1 - 2020/9
N2 - BACKGROUND: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events.PURPOSE: To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status.METHODS: AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated.RESULTS: 1956 patients (mean age 73.8 ± 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%;
p < .001) or renal disease (21.4% vs 15.9%;
p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year;
p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year;
p < .001) and MACE (12.9%/year vs 6.8%/year;
p < .001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 ± 24.37% vs 62.68 ± 25.31%;
p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80);
p = .024].
CONCLUSION: AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk.
AB - BACKGROUND: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events.PURPOSE: To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status.METHODS: AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated.RESULTS: 1956 patients (mean age 73.8 ± 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%;
p < .001) or renal disease (21.4% vs 15.9%;
p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year;
p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year;
p < .001) and MACE (12.9%/year vs 6.8%/year;
p < .001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 ± 24.37% vs 62.68 ± 25.31%;
p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80);
p = .024].
CONCLUSION: AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk.
KW - Atrial fibrillation
KW - diabetes mellitus
KW - oral anticoagulation
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85087020754&partnerID=8YFLogxK
U2 - 10.1080/07853890.2020.1778176
DO - 10.1080/07853890.2020.1778176
M3 - Journal article
C2 - 32500748
AN - SCOPUS:85087020754
SN - 0785-3890
VL - 52
SP - 300
EP - 309
JO - Annals of Medicine
JF - Annals of Medicine
IS - 6
ER -