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Outcomes of patients with atrial fibrillation on oral anticoagulation with and without heart failure: the ETNA-AF-Europe registry
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SYSNO ASEP 0576552 Document Type J - Journal Article R&D Document Type Journal Article Subsidiary J Článek ve WOS Title Outcomes of patients with atrial fibrillation on oral anticoagulation with and without heart failure: the ETNA-AF-Europe registry Author(s) Schnabel, R. B. (DE)
Ameri, P. (IT)
Siller-Matula, J. M. (AT)
Diemberger, I. (IT)
Gwechenberger, M. (AT)
Pecen, Ladislav (UIVT-O) RID, SAI, ORCID
Manu, M. C. (DE)
Souza, J. (DE)
De Caterina, R. (IT)
Kirchhof, P. (DE)Number of authors 10 Article number euad280 Source Title Europace - ISSN 1099-5129
Roč. 25, č. 9 (2023)Number of pages 12 s. Publication form Online - E Language eng - English Country GB - United Kingdom Keywords Atrial fibrillation ; Edoxaban ; Heart failure ; Left ventricular ejection fraction ; Non-vitamin K antagonist oral anticoagulant ; Registry OECD category Cardiac and Cardiovascular systems Method of publishing Open access Institutional support UIVT-O - RVO:67985807 UT WOS 001077827300002 EID SCOPUS 85172941085 DOI https://doi.org/10.1093/europace/euad280 Annotation AIMS: Heart failure (HF) is a risk factor for major adverse events in atrial fibrillation (AF). Whether this risk persists on non-vitamin K antagonist oral anticoagulants (NOACs) and varies according to left ventricular ejection fraction (LVEF) is debated. METHODS AND RESULTS: We investigated the relation of HF in the ETNA-AF-Europe registry, a prospective, multicentre, observational study with an overall 4-year follow-up of edoxaban-treated AF patients. We report 2-year follow-up for ischaemic stroke/transient ischaemic attack (TIA)/systemic embolic events (SEE), major bleeding, and mortality. Of the 13 133 patients, 1854 (14.1%) had HF. Left ventricular ejection fraction was available for 82.4% of HF patients and was <40% in 671 (43.9%) and ≥40% in 857 (56.1%). Patients with HF were older, more often men, and had more comorbidities. Annualized event rates (AnERs) of any stroke/SEE were 0.86%/year and 0.67%/year in patients with and without HF. Compared with patients without HF, those with HF also had higher AnERs for major bleeding (1.73%/year vs. 0.86%/year) and all-cause death (8.30%/year vs. 3.17%/year). Multivariate Cox proportional models confirmed HF as a significant predictor of major bleeding [hazard ratio (HR) 1.65, 95% confidence interval (CI): 1.20-2.26] and all-cause death [HF with LVEF <40% (HR 2.42, 95% CI: 1.95-3.00) and HF with LVEF ≥40% (HR 1.80, 95% CI: 1.45-2.23)] but not of ischaemic stroke/TIA/SEE. CONCLUSION: Anticoagulated patients with HF at baseline featured higher rates of major bleeding and all-cause death, requiring optimized management and novel preventive strategies. NOAC treatment was similarly effective in reducing risk of ischaemic events in patients with or without concomitant HF. Workplace Institute of Computer Science Contact Tereza Šírová, sirova@cs.cas.cz, Tel.: 266 053 800 Year of Publishing 2024 Electronic address https://dx.doi.org/10.1093/europace/euad280
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