Roberto Cemin1, Furio Colivicchi2, Aldo P Maggioni3, Giuseppe Boriani4, Leonardo De Luca5, Andrea Di Lenarda6, Giuseppe Di Pasquale7, Gianna Fabbri3, Donata Lucci3, Michele Massimo Gulizia8. 1. Cardiology Division, San Maurizio Regional Hospital of Bolzano, Bolzano, Italy. 2. Division of Cardiology, San Filippo Neri Hospital, Rome, Italy. 3. ANMCO Research Center of the Heart Care Foundation, Florence, Italy. 4. Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy. 5. Division of Cardiology, San Giovanni Evangelista Hospital, Tivoli, Italy. 6. Cardiovascular Center, University Hospital and Health Services of Trieste, Italy. 7. Division of Cardiology, Maggiore Hospital, Bologna, Italy. 8. ANMCO Research Center of the Heart Care Foundation, Florence, Italy; Cardiology Division, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi" Catania, Italy. Electronic address: blitz.af@anmco.it.
Abstract
BACKGROUND: The management of atrial fibrillation (AF) has changed with the introduction of direct anticoagulants (DOACs) and new techniques such as catheter ablation. An update collection of data from "real world" AF patients followed by cardiologists is useful to obtain information on both management, outcomes and guideline adherence in clinical practice. METHODS: Follow-up information on survival, embolic and bleeding events and hospital readmission, persistence of oral anticoagulant (OAC) therapy was collected in 84 centers participating to the BLITZ-AF study. RESULTS: Patients were followed for a median of 366 days (IQR: 356-378) and vital status was available for 2159 patients. Mortality was 9.2%. Heart failure was the most common cardiovascular cause of death (70%) followed by arrhythmias (6.7%), acute coronary syndrome (5.0%) and ischemic stroke (2.5%). During follow-up 18.1% of the patients were readmitted, mainly (81.3%) for cardiovascular causes. Patients on OAC were 83.4%, 9.1% were on antiplatelets and 7.5% did not receive antithrombotic therapy. The use of DOACs increased from 42.1% to 46.4% during the follow-up, OAC discontinuation occurred in 9.1%. AF recurrences occurred in 23.4% of the patients discharged in sinus rhythm. Rate control strategy was adopted in 55.9% and beta-blockers were the most used drugs (81.9%). Amiodarone (22%) and flecainide (9.7%) were the most frequent used antiahrrythmic drugs. CONCLUSIONS: The follow-up of the BLITZ-AF study provide an up to date picture of the clinical course of patients with AF, who appear frequently affected by heart failure and severe comorbidities which might have led to the high mortality rate.
BACKGROUND: The management of atrial fibrillation (AF) has changed with the introduction of direct anticoagulants (DOACs) and new techniques such as catheter ablation. An update collection of data from "real world" AFpatients followed by cardiologists is useful to obtain information on both management, outcomes and guideline adherence in clinical practice. METHODS: Follow-up information on survival, embolic and bleeding events and hospital readmission, persistence of oral anticoagulant (OAC) therapy was collected in 84 centers participating to the BLITZ-AF study. RESULTS:Patients were followed for a median of 366 days (IQR: 356-378) and vital status was available for 2159 patients. Mortality was 9.2%. Heart failure was the most common cardiovascular cause of death (70%) followed by arrhythmias (6.7%), acute coronary syndrome (5.0%) and ischemic stroke (2.5%). During follow-up 18.1% of the patients were readmitted, mainly (81.3%) for cardiovascular causes. Patients on OAC were 83.4%, 9.1% were on antiplatelets and 7.5% did not receive antithrombotic therapy. The use of DOACs increased from 42.1% to 46.4% during the follow-up, OAC discontinuation occurred in 9.1%. AF recurrences occurred in 23.4% of the patients discharged in sinus rhythm. Rate control strategy was adopted in 55.9% and beta-blockers were the most used drugs (81.9%). Amiodarone (22%) and flecainide (9.7%) were the most frequent used antiahrrythmic drugs. CONCLUSIONS: The follow-up of the BLITZ-AF study provide an up to date picture of the clinical course of patients with AF, who appear frequently affected by heart failure and severe comorbidities which might have led to the high mortality rate.
Authors: Gregory Y H Lip; Giuseppe Boriani; Vincenzo L Malavasi; Marco Vitolo; Jacopo Colella; Francesca Montagnolo; Marta Mantovani; Marco Proietti; Tatjana S Potpara Journal: Intern Emerg Med Date: 2021-12-02 Impact factor: 5.472