Prevalence, clinical profile, and cardiovascular outcomes of atrial fibrillation patients with atherothrombosis - 08/08/11
, Deepak L. Bhatt, MD b, Joachim Röther, MD c, Mark Alberts, MD d, Michael D. Hill, MD e, Yasuo Ikeda, MD f, Shinichiro Uchiyama, MD, PhD g, Ralph D'Agostino, PhD h, E. Magnus Ohman, MD i, Chiau-Suong Liau, MD, PhD j, Alan T. Hirsch, MD k, Jean-Louis Mas, MD l, Peter W.F. Wilson, MD m, Ramón Corbalán n, Franz Aichner, MD o, P. Gabriel Steg, MD pon behalf of the REACH Registry Investigatorsq
Résumé |
Background |
Atrial fibrillation (AF) is a major risk factor (RF) for ischemic stroke. Its prevalence and prognostic impact in patients with atherothrombosis are unclear.
Methods |
Risk factors, drug usage, and 1-year cardiovascular (CV) outcomes (CV death, myocardial infarction [MI], and stroke) were compared in AF and non-AF patients from the REduction of Atherothrombosis for Continued Health (REACH) Registry, an international, prospective cohort of 68,236 stable outpatients with established atherothrombosis or ≥3 atherothrombotic RFs.
Results |
Atrial fibrillation and 1-year follow-up data are available for 63,589 patients. The prevalence of AF was, 12.5%, 13.7%, 11.5%, and 6.2% among coronary artery disease, CV disease, peripheral artery disease, and RF-only patients, respectively. Of the 6,814 patients with AF, 6.7% experienced CV death, nonfatal MI, or nonfatal stroke within a year. The annual incidence of nonfatal stroke (2.4% vs 1.6%, P < .0001) and unstable angina (6.0% vs 4.0%, P < .00001) was higher, and CV death was more than double (3.2% vs 1.4%, P < .0001), in AF versus non-AF patients. In these patients with or at high risk of atherothrombosis, most patients with AF received antiplatelet agents, but only 53.1% were treated with oral anticoagulants. Even with high CHADS2 (congestive heart failure, hypertension, aging, diabetes mellitus, and stroke) scores, anticoagulant use did not exceed (59%). The rate of bleeding requiring hospitalization was higher in AF versus non-AF patients (1.5% vs 0.8%, P < .0001), possibly related to the more frequent use of anticoagulants (53.1% vs 7.1%).
Conclusions |
Atrial fibrillation is common in patients with atherothrombosis, associated with more frequent fatal and nonfatal CV outcomes, and underuse of oral anticoagulants.
Le texte complet de cet article est disponible en PDF.Plan
| Author conflict of interest information is available in Appendix A available online. |
Vol 156 - N° 5
P. 855 - novembre 2008 Retour au numéro
Article précédent
- Electrical storm in patients with biventricular implantable cardioverter defibrillator: Incidence, predictors, and prognostic implications
- Maurizio Gasparini, Maurizio Lunati, Maurizio Landolina, Massimo Santini, Luigi Padeletti, Gianni Perego, Antonio Vincenti, Antonio Curnis, Angelo Carboni, Alessandra Denaro, Alessia Spotti, Andrea Grammatico, François Regoli, Giuseppe Boriani, on behalf of the InSync ICD Italian Registry Investigators
- Decreased complication rates using the transradial compared to the transfemoral approach in percutaneous coronary intervention in the era of routine stenting and glycoprotein platelet IIb/IIIa inhibitor use: A large single-center experience
- Jonas Eichhöfer, Eric Horlick, Joan Ivanov, Peter H. Seidelin, John R. Ross, Douglas Ing, Paul Daly, Karen Mackie, Brenda Ridley, Leonard Schwartz, Alan Barolet, Vladimír Džavík
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?