Giuseppe Boriani1, Marco Proietti2, Cécile Laroche3, Igor Diemberger4, Mircea Ioachim Popescu5, Sam Riahi6, Alena Shantsila7, Gheorghe-Andrei Dan8, Luigi Tavazzi9, Aldo P Maggioni10, Gregory Y H Lip11. 1. Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy. Electronic address: giuseppe.boriani@unimore.it. 2. Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom; IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. 3. EURObservational Research Programme Department, European Society of Cardiology, Sophia Antipolis, France. 4. Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, S.Orsola-Malpighi University Hospital, Bologna, Italy. 5. County Emergency Hospital, Oradea, Romania. 6. Department of Cardiology, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 7. Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom. 8. University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania. 9. Maria Cecilia Hospital, GVM Care&Research. E.S. Health Science Foundation, Cotignola, Italy. 10. EURObservational Research Programme Department, European Society of Cardiology, Sophia Antipolis, France; ANMCO Research Center, Firenze, Italy. 11. Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
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.
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 AFpatients 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.
Authors: Vincenzo Livio Malavasi; Elisa Fantecchi; Virginia Tordoni; Laura Melara; Andrea Barbieri; Marco Vitolo; Gregory Y H Lip; Giuseppe Boriani Journal: Intern Emerg Med Date: 2020-11-07 Impact factor: 3.397
Authors: Raffaele De Caterina; Peter Kelly; Pedro Monteiro; Jean Claude Deharo; Carlo de Asmundis; Esteban López-de-Sá; Thomas W Weiss; Johannes Waltenberger; Jan Steffel; Joris R de Groot; Pierre Levy; Ameet Bakhai; Wolfgang Zierhut; Petra Laeis; Michael Kerschnitzki; Paul-Egbert Reimitz; Paulus Kirchhof Journal: BMC Cardiovasc Disord Date: 2019-07-12 Impact factor: 2.298
Authors: Giuseppe Boriani; Gregory Y H Lip; Marco Proietti; Marco Vitolo; Stephanie L Harrison; Deirdre A Lane; Laurent Fauchier; Francisco Marin; Michael Nabauer; Tatjana S Potpara; Gheorghe-Andrei Dan Journal: Clin Res Cardiol Date: 2021-08-27 Impact factor: 5.460