Marco Proietti1, Irene Marzona2, Tommaso Vannini2, Mauro Tettamanti2, Ida Fortino3, Luca Merlino3, Stefania Basili4, Pier Mannuccio Mannucci5, Giuseppe Boriani6, Gregory Y H Lip7, Maria Carla Roncaglioni2, Alessandro Nobili2. 1. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom; Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. Electronic address: marco.proietti@unimi.it. 2. Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. 3. Regional Ministry of Health, Lombardy Region, Milan, Italy. 4. Department of Translational and Precision Medicine, Sapienza-University of Rome, Rome, Italy. 5. Scientific Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 6. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy. 7. Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
OBJECTIVES: To analyze the relationship between atrial fibrillation (AF) and Charlson comorbidity index (CCI) in a population-based cohort study over a long-term follow-up period, in relation to oral anticoagulant (OAC) prescriptions and outcomes. PATIENTS AND METHODS: We used data from the administrative health databases of Lombardy. All patients with AF and age 40 years and older and who were admitted to the hospital in 2002 were considered for analysis and followed up to 2014. AF diagnosis and CCI were established according to codes from the International Classification of Diseases, Ninth Revision. RESULTS: In 2002, 24,040 patients were admitted with a diagnosis of AF. CCI was higher in patients with AF than in those without AF (1.8±2.1 vs 0.2±0.9; P<.001). Over 12 years of follow-up, AF was associated with an increased risk of higher CCI (beta coefficient, 1.69; 95% CI, 1.67-1.70). In patients with AF, CCI was inversely associated with OAC prescription at baseline (P<.001) and at the end of the follow-up (P=.03). Patients with AF and a high CCI (≥4) had a higher cumulative incidence of stroke, major bleeding, and all-cause death (all P<.001), compared with those with low CCI (range, 0-3). Adjusted Cox regression analysis revealed that time-dependent continuous CCI was associated with an increased risk for stroke, major bleeding, and all-cause death (all P<.001). CONCLUSIONS: In hospitalized patients, AF is associated with an increase in CCI that is inversely associated with OAC prescriptions during follow-up. CCI is independently associated with an increased risk of stroke, major bleeding, and all-cause death.
OBJECTIVES: To analyze the relationship between atrial fibrillation (AF) and Charlson comorbidity index (CCI) in a population-based cohort study over a long-term follow-up period, in relation to oral anticoagulant (OAC) prescriptions and outcomes. PATIENTS AND METHODS: We used data from the administrative health databases of Lombardy. All patients with AF and age 40 years and older and who were admitted to the hospital in 2002 were considered for analysis and followed up to 2014. AF diagnosis and CCI were established according to codes from the International Classification of Diseases, Ninth Revision. RESULTS: In 2002, 24,040 patients were admitted with a diagnosis of AF. CCI was higher in patients with AF than in those without AF (1.8±2.1 vs 0.2±0.9; P<.001). Over 12 years of follow-up, AF was associated with an increased risk of higher CCI (beta coefficient, 1.69; 95% CI, 1.67-1.70). In patients with AF, CCI was inversely associated with OAC prescription at baseline (P<.001) and at the end of the follow-up (P=.03). Patients with AF and a high CCI (≥4) had a higher cumulative incidence of stroke, major bleeding, and all-cause death (all P<.001), compared with those with low CCI (range, 0-3). Adjusted Cox regression analysis revealed that time-dependent continuous CCI was associated with an increased risk for stroke, major bleeding, and all-cause death (all P<.001). CONCLUSIONS: In hospitalized patients, AF is associated with an increase in CCI that is inversely associated with OAC prescriptions during follow-up. CCI is independently associated with an increased risk of stroke, major bleeding, and all-cause death.
Authors: Agnieszka Kotalczyk; Michał Mazurek; Zbigniew Kalarus; Tatjana S Potpara; Gregory Y H Lip Journal: Nat Rev Cardiol Date: 2020-10-27 Impact factor: 32.419
Authors: Steven Deitelzweig; Allison Keshishian; Amiee Kang; Amol D Dhamane; Xuemei Luo; Christian Klem; Lisa Rosenblatt; Jack Mardekian; Jenny Jiang; Huseyin Yuce; Gregory Y H Lip Journal: Adv Ther Date: 2021-05-07 Impact factor: 3.845
Authors: Giuseppe Boriani; Marco Vitolo; Igor Diemberger; Marco Proietti; Anna Chiara Valenti; Vincenzo Livio Malavasi; Gregory Y H Lip Journal: Cardiovasc Res Date: 2021-06-16 Impact factor: 13.081
Authors: Marco Proietti; Giulio Francesco Romiti; Brian Olshansky; Deirdre A Lane; Gregory Y H Lip Journal: J Am Heart Assoc Date: 2020-05-06 Impact factor: 5.501