The effect of treatment strategy on long-term follow-up results in patients with nonvalvular atrial fibrillation in Turkey: AFTER-2 subgroup analysis

Kılıç, Raif; Güzel, Tuncay; Aktan, Adem; Demir, Muhammed; Arslan, Bayram; Ertaş, Faruk

doi:10.1007/s40520-023-02467-y

Cited by 6 publications

(8 citation statements)

References 28 publications

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“… 55 In another study, which compared treatment techniques of rate control and rhythm control in NVAF patients, no difference in fatality rates was reported. 56 Furthermore, studies have shown that Artificial Intelligence (AI) algorithms can assist health-care professionals in selecting the most effective AF treatment helping determine the best treatment strategy and helping to improve the treatment outcome. 57 …”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Treatment Outcomes of Acute Ischemic Stroke with Atrial Fibrillation Among Patients Admitted to Tertiary Care Hospitals in Amhara Regional State: Retrospective-Cohort Study

Addisu,

Mega

2023

VHRM

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Background Atrial fibrillation (AF) is the leading cause of a surge in hospital expenses for the treatment of strokes. However, evidence regarding clinical features and survival of patients admitted with acute ischemic stroke (AIS) plus AF in Ethiopia is lacking. Objective We assess clinical characteristics, survival, and predictors of mortality of patients with acute ischemic stroke and atrial fibrillation among patients admitted to Tertiary Care Hospitals in Amhara regional state. Methods A retrospective cohort study was done on patients diagnosed with AIS who received care at Tibebe Ghion and Felege Hiwot hospitals from November 2018 to November 2021. Data were analyzed using SPSS version 25. Cox regression analysis was used to identify predictors of in-hospital mortality. Kaplan–Meier analysis was used to identify survival rates and mean survival time. The hazard ratio was used as a measure of the strength of the association and statistical significance was declared at p-value <0.05. Results Of 378 patients with AIS, 58.7% were male. AF was diagnosed in 102 (26.9%) patients. Compared with patients without AF, patients with AF were more likely to have Glasgow Coma Scale <8 (83.3 vs 4%), valvular heart disease (56.9 vs 4.7%), and coronary heart disease (11.8 vs 4%). Patients with AF had a significant incidence of in-hospital mortality (38 per 1000 vs 17 per 1000) person-days. Glasgow Coma Scale <8: (AHR=12.69, 95% CI: [2.603–61.873]), aspirational pneumonia (AHR=2.602, 95% CI: 1.085–6.242), acute renal failure (AHR=6.114, 95% CI: [1.817–20.576]), hypokalemia (AHR=1.179, 95% CI: [1.112,-3.373]), atrial fibrillation (AHR=1.104, 95% CI: [1.015–5.404]), HIV/AIDS (AHR=8.302, 95% CI: [1.585–43.502]) and chronic liver disease (AHR=4.969, 95% CI: [1.192–20.704]) were indicators of in-hospital mortality. Conclusion In the current study, hospital mortality was greater in AIS associated with atrial fibrillation. Stroke-related complications were significant predictors of mortality. Hence, effective strategies should be in place to curb the impacts of these factors.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Treatment Outcomes of Acute Ischemic Stroke with Atrial Fibrillation Among Patients Admitted to Tertiary Care Hospitals in Amhara Regional State: Retrospective-Cohort Study

Addisu,

Mega

2023

VHRM

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“…Atrial fibrillation (AF) is the most common cardiac arrhythmia, and the leading cause of cardioembolic stroke, 1 , 2 with a prevalence ranging from 0.1% in patients below 55 years to over 9% in octogenarian patients, and fivefold elevation in the risk of ischemic stroke (IS) among individuals with AF. 3 It has been well accepted that oral anticoagulants substantially reduce the risk for IS in patients with AF determined to be at intermediate to high risk for thromboembolism.…”

Section: Introductionmentioning

confidence: 99%

Patients with Atrial Fibrillation are Unlikely to Benefit from Aspirin Monotherapy

Wang,

Hou,

et al. 2024

IJGM

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Background Aspirin (ASA), the mainstay antiplatelet treatment in patients with cardiovascular disease (CVD), has been received by a considerable number of AF patients. This study sought to examine the association between ASA monotherapy and the risk of major adverse cardiac and cerebrovascular events (MACCE) in patients with atrial fibrillation (AF). Methods A total of 850 patients with AF were identified from a community-based Kailuan study. All patients were assigned to two groups according to their medicine history: an aspirin therapy group (ASA group) (n = 174), and a non-aspirin therapy group (non-ASA group) (n = 676). The clinical endpoints are MACCE, including myocardial infarction (MI), ischemic stroke (IS), and hemorrhagic stroke (HS). Incidence curves for MACCE were plotted using the Kaplan–Meier method, and the Log rank test was used to assess the differences in incidence rates. The hazard ratios (HR) and 95% confidence intervals (CI) for MACCE were analyzed using Cox proportional-hazards analysis regression models. Results During the 7.2-year follow-up, 30 MACCE occurred in the ASA group, and 101 in the non-ASA group, with a cumulative incidence of 19.88% vs 17.27%, P = 0.511; 3 cases of MI occurred in the ASA group, and 18 cases in the non-ASA group, with a cumulative incidence of 1.78% vs 2.90%, P = 0.305. Twenty-seven cases of IS occurred in the ASA group, and 84 cases in the non-ASA group, with a cumulative incidence of 1.78% vs 2.90%, P = 0.305. Eight cases of HS occurred in the ASA group, and 13 cases in the non-ASA group, with a cumulative incidence of 5.01% vs 2.34%, P = 0.045. Multivariate regression analysis showed that ASA therapy was not associated with MACCE (HR: 1.130, 95% CI: 0.747–1.710, P = 0.562). In addition, ASA therapy was not associated with IS (HR: 1.309, 95% CI: 0.843–2.034, P = 0.231). However, ASA therapy was significantly associated with HS (HR: 2.563, 95% CI: 1.024–6.418, P = 0.044). Conclusion ASA monotherapy is not associated with a lower risk of ischemic events, while significantly associated with a higher risk of bleeding events. Patients with AF are unlikely to benefit from aspirin monotherapy.

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“…AF significantly heightens the risk of stroke, heart failure, and mortality [ 4 – 7 ]. Although many risk factors for atrial fibrillation have already been identified, including age, hypertension, diabetes, obesity, left atrial volume and smoking [ 8 – 10 ], the potential modifiable risk factors still need to be investigated.…”

Section: Introductionmentioning

confidence: 99%

Association of red cell distribution width/albumin ratio and in hospital mortality in patients with atrial fibrillation base on medical information mart for intensive care IV database

Pan,

Song

2024

BMC Cardiovasc Disord

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Background Atrial fibrillation (AF) is a common cardiac arrhythmia. The ratio of red cell distribution width (RDW) to albumin has been recognized as a reliable prognostic marker for poor outcomes in a variety of diseases. However, the evidence regarding the association between RDW to albumin ratio (RAR) and in hospital mortality in patients with AF admitted to the Intensive Care Unit (ICU) currently was unclear. The purpose of this study was to explore the association between RAR and in hospital mortality in patients with AF in the ICU. Methods This retrospective cohort study used data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database for the identification of patients with atrial fibrillation (AF). The primary endpoint investigated was in-hospital mortality. Multivariable-adjusted Cox regression analysis and forest plots were utilized to evaluate the correlation between the RAR and in-hospital mortality among patients with AF admitted to ICU. Additionally, receiver operating characteristic (ROC) curves were conducted to assess and compare the predictive efficacy of RDW and the RAR. Results Our study included 4,584 patients with AF with a mean age of 75.1 ± 12.3 years, 57% of whom were male. The in-hospital mortality was 20.3%. The relationship between RAR and in-hospital mortality was linear. The Cox proportional hazard model, adjusted for potential confounders, found a high RAR independently associated with in hospital mortality. For each increase of 1 unit in RAR, there is a 12% rise in the in-hospital mortality rate (95% CI 1.06–1.19). The ROC curves revealed that the discriminatory ability of the RAR was better than that of RDW. The area under the ROC curves (AUCs) for RAR and RDW were 0.651 (95%CI: 0.631–0.671) and 0.599 (95% CI: 0.579–0.620). Conclusions RAR is independently correlated with in hospital mortality and in AF. High level of RAR is associated with increased in-hospital mortality rates.

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The effect of treatment strategy on long-term follow-up results in patients with nonvalvular atrial fibrillation in Turkey: AFTER-2 subgroup analysis

Cited by 6 publications

References 28 publications

Clinical Characteristics and Treatment Outcomes of Acute Ischemic Stroke with Atrial Fibrillation Among Patients Admitted to Tertiary Care Hospitals in Amhara Regional State: Retrospective-Cohort Study

Clinical Characteristics and Treatment Outcomes of Acute Ischemic Stroke with Atrial Fibrillation Among Patients Admitted to Tertiary Care Hospitals in Amhara Regional State: Retrospective-Cohort Study

Patients with Atrial Fibrillation are Unlikely to Benefit from Aspirin Monotherapy

Association of red cell distribution width/albumin ratio and in hospital mortality in patients with atrial fibrillation base on medical information mart for intensive care IV database

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