SummaryBackground: Patients with atrial fibrillation (AF) have a higher mortality and risk of stroke/embolism than patients with sinus rhythm.Hypothesis: The aim of the study was to assess the association of clinical and echocardiographic characteristics with mortality and stroke/embolism and the use of antithrombotic medication in the year 2000 in patients who participated 1990-1995 in the Embolism in Left Atrial Thrombi (ELAT) study.Methods: The study included 409 outpatients with nonrheumatic AF (62 ± 12 years, 36% women, 39% intermittent AF). Patients with thrombi received anticoagulation, patients without thrombi aspirin until follow-up in 1995; thereafter, anticoagulation according to clinical risk factors was recommended. Primary events were death and secondary events were stroke/embolism. All patients were contacted during the year 2000.Results: Mean follow-up was 102 months. Mortality was 4%/year; the cause of death was cardiac (n = 84), fatal stroke (n = 26), malignancy (n = 23), sepsis (n = 5), and unknown (n = 24). Multivariate analysis identified age (p < 0.0001), heart failure (p = 0.0013), and reduced left ventricular systolic function (p = 0.0353) as predictors of mortality. Stroke/embolism occurred in 83 patients, with a rate of 3%/year. Multivariate analysis identified age (p = 0.0006) and previous stroke (p = 0.0454) as predictors of stroke/embolism. In the year 2000, 51

Diabetic patients with atrial fibrillation frequently have additional risk factors for stroke or embolism, and thus should be treated with oral anticoagulation. Whether in the rare cases of atrial fibrillation, in whom diabetes is the only clinical risk factor, oral anticoagulation is indicated cannot be answered by the present study.

Background and Purpose-We sought to assess in outpatients with atrial fibrillation and oral anticoagulation (1) whether the complication rate is influenced by the presence of the risk factors age Ͼ65 years, arterial hypertension, diabetes, or previous stroke; (2) whether the complication rate is influenced by the number of additional drugs taken by patients; and (3)

By careful monitoring, eliminating potential bleeding sources, treating pain adequately and minimizing additional drugs the complications of OAC can be kept low.

In a double-blind, placebo-controlled, randomized, cross-over trial, we studied the effects of the muscarinic M1-receptor-selective antagonist (+/-)-telenzepine (3 mg orally at 6 p.m. for 5 days) in 21 patients with chronic obstructive pulmonary disease (COPD). At enrollment all patients showed at least a 50% decrease in airway resistance (Raw) after inhalation of 400 micrograms fenoterol or 200 micrograms oxitropium bromide. Telenzepine did not have a significant effect on forced expiratory volume in one second (FEV1) or forced vital capacity (FVC). Also, no significant changes could be detected in daily spirometric profiles or Raw. The results indicate that short-term treatment with the M1-selective antagonist, telenzepine, does not improve airway function in COPD patients, at least after administration by the oral route.