Changes to oral anticoagulant therapy and risk of death over a 3-year follow-up of a contemporary cohort of European patients with atrial fibrillation final report of the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) pilot general registry

Boriani, Giuseppe; Proietti, Marco; Laroche, Cécile; Diemberger, Igor; Popescu, Mircea Ioachim; Riahi, Sam; Shantsila, Alena; Dan, Gheorghe‐Andrei; Tavazzi, Luigi; Maggioni, Aldo P.; Lip, Gregory Y.H.; Investigators, Eorp-Af Pilot General Registry

doi:10.1016/j.ijcard.2018.05.034

Cited by 34 publications

(40 citation statements)

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“…Oral anticoagulation (vitamin K antagonist/direct oral anticoagulant) and antiplatelet therapy in atrial fibrillation population Almost a third of patients with AF did not receive anticoagulants during the observation period. This is consistent with data from the EORP-AF pilot registry, 16 in which OAC was used in 80.1% of patients with AF. Other contemporary registries presenting data on OAC in the general AF population report rates of anticoagulation that vary from 46% to 97%.…”

Section: Atrial Fibrillation In Different Cardiomyopathy Populationssupporting

confidence: 90%

“…In a cohort of European patients with AF from the EORP-AF pilot registry, the composite of stroke/TIA/peripheral embolism/all-cause death at 3 years occurred in 18.2%. 16 The incidence of death from any cause (5.59% vs. 2.50%) and death from heart failure (2.44% vs. 1.41%) was twice higher in AF population than in non-AF population. Similar observations regarded our AF and non-AF subjects with DCM.…”

Section: Clinical Endpoints and Risk Factors For Stroke/transient Iscmentioning

confidence: 88%

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Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology

et al. 2020

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Aims Cardiomyopathies are a heterogeneous group of disorders that increase the risk for atrial fibrillation (AF). The aim of the study is to assess the prevalence of AF, anticoagulation management, and risk of stroke/transient ischaemic attack (TIA) in patients with cardiomyopathy. Methods and results Three thousand two hundred eight consecutive adult patients with cardiomyopathy (34.9% female; median age: 55.0 years) were prospectively enrolled as part of the EURObservational Research Programme Cardiomyopathy/Myocarditis Registry. At baseline, 903 (28.2%) patients had AF (29.4% dilated, 27.5% hypertrophic, 51.5% restrictive, and 14.7% arrhythmogenic right ventricular cardiomyopathy, P < 0.001). AF was associated with more advanced New York Heart Association class (P < 0.001), increased prevalence of cardiovascular risk factors and co-morbidities, and a history of stroke/TIA (P < 0.001). Oral anticoagulation was administered in 71.7% of patients with AF (vitamin K antagonist: 51.6%; direct oral anticoagulant: 20.1%). At 1 year follow-up, the incidence of cardiovascular endpoints was as follows: stroke/TIA 1.85% (AF vs. non-AF: 3.17% vs. 1.19%, P < 0.001), death from any cause 3.43% (AF vs. non-AF: 5.39% vs. 2.50%, P < 0.001), and death from heart failure 1.67% (AF vs. non-AF: 2.44% vs. 1.31%, P = 0.033). The independent predictors for stroke/TIA were as follows: AF [odds ratio (OR) 2.812, P = 0.005], history of stroke (OR 7.311, P = 0.010), and anaemia (OR 3.119, P = 0.006). Conclusions The study reveals a high prevalence and diverse distribution of AF in patients with cardiomyopathies, inadequate anticoagulation regimen, and high risk of stroke/TIA in this population.

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Section: Atrial Fibrillation In Different Cardiomyopathy Populationssupporting

confidence: 90%

Section: Clinical Endpoints and Risk Factors For Stroke/transient Iscmentioning

confidence: 88%

Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology

et al. 2020

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“…In view of its epidemiological profile, AF affects subjects in the range of age at highest risk of adverse outcomes if infected by Sars-Cov-2 [33] and the caution in avoiding admissions to hospital may explain the important reduction in acute pharmacological and non-pharmacological treatments applied for AF in emergency setting reported during the study period, as reported in this survey. Since appropriate prescription of oral anticoagulants in patients at risk of stroke is a major determinant of outcome at long term [34][35][36][37][38][39][40], it will be necessary in the near future to establish even stricter connections between hospital and out of hospital care, for a re-assessment of patients who presented AF and these months with regard to clinical evaluation and appropriateness of treatment for ensuring continuity of care. It will also be interesting to assess to what extent untreated or undiscovered AF occurred during the lockdown will result in major consequences, such as syncope, heart failure, stroke/systemic embolism [41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Boriani

Palmisano²,

Guerra

et al. 2020

Intern Emerg Med

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COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March-April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy.

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“…4 Atrial fibrillation is associated to an increased risk of stroke, cardiovascular events and cardiovascular or all-cause death. 1,5 In the context of critically ill patients, AF is associated to a deterioration of haemodynamic state, 4 as well as an increased stroke risk, 6 acute decompensated heart failure (AHF) 7 and death. 3 In hospitalized patients, new-onset AF does not independently predict in-hospital death, 8 pre-existing AF is an independent risk factor for in-hospital mortality and worse functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

Impact of atrial fibrillation in critically ill patients admitted to a stepdown unit

Falsetti

Proietti

Zaccone

et al. 2020

Eur J Clin Investigation

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Background: Limited data are available on the clinical course of patients with history of atrial fibrillation (AF) when admitted in an intensive care environment. We aimed to describe the occurrence of major adverse events in AF patients admitted to a stepdown care unit (SDU) and to analyse clinical factors associated with outcomes, impact of dicumarolic oral anticoagulant (OAC) therapy impact and performance of clinical risk scores in this setting. Materials and methods: Single-centre, observational retrospective analysis on a population of subjects with AF history admitted to a SDU. Therapeutic failure (composite of transfer to ICU or death) was considered the main study outcome. Occurrence of stroke and major bleeding (MH) was considered as secondary outcomes. The performance of clinical risk scores was evaluated. Results: A total of 1430 consecutive patients were enrolled. 194 (13.6%) reported the main outcome. Using multivariate logistic regression, age (odds ratio [OR]: 1.03, 95% confidence interval [

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Changes to oral anticoagulant therapy and risk of death over a 3-year follow-up of a contemporary cohort of European patients with atrial fibrillation final report of the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) pilot general registry

Cited by 34 publications

References 31 publications

Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology

Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Impact of atrial fibrillation in critically ill patients admitted to a stepdown unit

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