Características clínicas, manejo y riesgo de complicaciones a un año en pacientes con insuficiencia cardíaca con y sin diabetes tipo 2 en España

Escobar, Carlos; Varela, Luis; Palacios, Beatriz; Capel, Margarita; Sicras‐Mainar, Antoni; Sicras-Navarro, Aram; Hormigo, Antonio; Alcázar, Roberto; Manito, Nicolás; Botana, Manuel

doi:10.1016/j.rce.2021.04.008

Cited by 11 publications

(9 citation statements)

References 42 publications

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“…Although some authors have not shown significant differences in the strength of an association between AF and the type of HF [8], other authors have reported that among HF patients, AF is progressively more common with increasing LVEF [28,30,31].…”

Section: Discussionmentioning

confidence: 99%

“…In the international GLORIA-AF registry, in which AF patients anticoagulated with a direct oral anticoagulant were enrolled, 24% of patients had HF at baseline [ 27 ]. Conversely, different studies have shown that approximately one third of patients with HF also have AF [ 28 , 29 ]. As each entity enhances the development of the other one [ 5 , 6 ], an active search should be promoted to rule out the concomitance of both conditions [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, more patients had HFpEF than HFrEF or HFmrEF. Although some authors have not shown significant differences in the strength of an association between AF and the type of HF [ 8 ], other authors have reported that among HF patients, AF is progressively more common with increasing LVEF [ 28 , 30 , 31 ]. Despite previous studies showing that HFpEF accounts for at least half of the cases of HF, it is very likely that due to the ageing of the population, this proportion will increase in the following years, as well as the number of patients with AF and HF concomitantly [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study

et al. 2022

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Background:The aim of this study was to analyze the impact of the presence of heart failure (HF) on the clinical profile and outcomes in patients with atrial fibrillation (AF) anticoagulated with rivaroxaban.Methods: Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before inclusion.Data were analyzed according to baseline HF status.Results: Out of 1,433 patients, 326 (22.7%) had HF at baseline. Compared to patients without HF, HF patients were older (75.3 ± 9.9 vs. 73.8 ± 9.6 years; p = 0.01), had more diabetes (36.5% vs. 24.3%; p < 0.01), coronary artery disease (28.2% vs. 12.9%; p < 0.01), renal insufficiency (31.7% vs. 22.6%; p = 0.01), higher CHA 2 DS 2 -VASc (4.5 ± 1.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study

et al. 2022

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“…With regard to HF treatments, the majority of patients were taking the appropriate disease‐modifying treatment, as guidelines recommend (86% a renin‐angiotensin system inhibitor, 80% a beta blocker, and half of patients a mineralocorticoid receptor antagonists) 15 . These numbers are higher than those reported in previous studies performed in the overall HF population 5,6 . Despite that, the number of hospitalizations and/or visits to the emergency department due to HF during the follow‐up persisted high, being HF worsening/progression the main cause.…”

Section: Discussionmentioning

confidence: 86%

“…Heart failure (HF) and atrial fibrillation (AF) are two common conditions that frequently coexist 1,2 . In fact, it has been estimated that up to 30% of patients with AF have HF, and conversely, around one‐third of patients with HF have concomitantly AF 3–6 . In fact, both entities share many risk factors (i.e., hypertension, diabetes, aging, obesity, etc.)…”

Section: Introductionmentioning

confidence: 99%

Outcomes and factors associated with mortality in patients with atrial fibrillation and heart failure: FARAONIC study

Gómez Doblas,

Cepeda‐Rodrigo,

Agra Bermejo

et al. 2023

Clinical Cardiology

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BackgroundHeart failure (HF) and atrial fibrillation (AF) are common and coexistent conditions.HypothesisTo investigate the adverse events and mortality risk factors in patients with AF and HF treated with rivaroxaban in Spain.MethodsMulticenter, prospective and observational study with a follow‐up of 2 years, that included adults, with a diagnosis of nonvalvular AF and chronic HF, anticoagulated with rivaroxaban at least 4 months before being enrolled.ResultsA total of 672 patients from 71 Spanish centers were recruited, of whom 658 (97.9%) were included in the safety analysis and 552 (82.1%) in the per protocol analysis. At baseline, the mean age was 73.7 ± 10.9 years, 65.9% were male, 51.3% had HF with preserved ejection fraction and 58.7% were on New York Heart Association functional class II. CHA2DS2‐VASc was 4.1 ± 1.5. During the follow‐up, 11.6% of patients died and around one‐quarter of patients were hospitalized or visited the emergency department, being HF worsening/progression the main cause (51.1%), with a 2.9% of thromboembolic events and 2.0% of acute coronary syndromes. Major bleeding occurred in 3.1% of patients, with 0.5% experiencing intracranial bleeding but no fatalities. Compliance with HF treatment was associated with a lower risk of death (hazard ratio: 0.092; 95% confidence interval: 0.03–0.31).ConclusionsAmong patients with HF and AF anticoagulated with rivaroxaban, incidences of thromboembolic or hemorrhagic complications were low. The most important factor for improving survival was compliance with HF drugs, what strengths the need for early treatment with HF disease‐modifying therapy and anticoagulation.

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Factors associated with disease progression in patients with atrial fibrillation and heart failure anticoagulated with rivaroxaban

Manito,

Cepeda‐Rodrigo,

Farré

et al. 2023

Clinical Cardiology

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BackgroundPatients with atrial fibrillation (AF) and heart failure (HF) have a high risk of thromboembolism and other outcomes and anticoagulation is recommended.HypothesisThis study was aimed to explore the risk factors associated with HF worsening in patients with AF and HF taking rivaroxaban in Spain.MethodsMulticenter, prospective, observational study that included adults with AF and chronic HF, receiving rivaroxaban ≥4 months before entering. HF worsening was defined as first hospitalization or emergency visit because of HF exacerbation.ResultsA total of 672 patients from 71 Spanish centers were recruited, of whom 658 (97.9%) were included in the safety analysis and 552 (82.1%) in the per protocol analysis. At baseline, mean age was 73.7 ± 10.9 years, 64.9% were male, CHA2DS2‐VASc was 4.1 ± 1.5, HAS‐BLED was 1.6 ± 0.9% and 51.3% had HF with preserved ejection fraction. After 24 months of follow‐up, 24.9% of patients developed HF worsening, 11.6% died, 2.9% had a thromboembolic event, 3.1% a major bleeding, 0.5% an intracranial bleeding and no patient had a fatal hemorrhage. Older age, the history of chronic obstructive pulmonary disease, the previous use of vitamin K antagonists, and restrictive or infiltrative cardiomyopathies, were independently associated with HF worsening. Only 6.9% of patients permanently discontinued rivaroxaban treatment.ConclusionsApproximately one out of four patients with HF and AF treated with rivaroxaban developed a HF worsening episode after 2 years of follow‐up. The identification of those factors that increase the risk of HF worsening could be helpful in the comprehensive management of this population.

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Características clínicas, manejo y riesgo de complicaciones a un año en pacientes con insuficiencia cardíaca con y sin diabetes tipo 2 en España

Cited by 11 publications

References 42 publications

Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study

Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study

Outcomes and factors associated with mortality in patients with atrial fibrillation and heart failure: FARAONIC study

Factors associated with disease progression in patients with atrial fibrillation and heart failure anticoagulated with rivaroxaban

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