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

ESC Heart Failure

Yigal Pinto¹  Juan R. Gimeno²  Maria Luisa Pena‐Pena³  Akinsanya Olusegun‐Joseph⁴  Philippe Charron⁵  Juan Pablo Kaski⁶  Attila Frigy⁷  Michał Tendera⁸  Fabrizio Drago⁹  Alida L.P. Caforio^1,10  Cecile Laroche^1,11  Aldo P. Maggioni^1,11  Katarzyna Mizia‐Stec^1,12  Olga Blagova^1,13  Perry Elliott^1,14  Luigi Tavazzi^1,15  Angelos G. Rigopoulos^1,16  Elena Reznik^1,17  Elisabetta Zachara^1,18  Simone Sala^1,19 

[1] Academic Medical Center Amsterdam The Netherlands;Cardiac Department Hospital Universitario Virgen de la Arrixaca Murcia Spain;Cardiac Imaging and Inherited Cardiac Diseases Unit, Department of Cardiology Virgen del Rocio University Hospital Seville Spain;Cardiology Unit, Department of Medicine, College of Medicine University of Lagos, Lagos University Teaching Hospital Lagos Nigeria;Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique‐Hôpitaux de Paris, ICAN, Hôpital Pitié‐Salpêtrière Paris France;Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital London UK;Clinical County Hospital Târgu Mureș Romania;Department of Cardiology and Structural Heart Disease, School of Medicine in Katowice Medical University of Silesia Katowice Poland;Department of Pediatric Cardiology Bambino Gesù Children's Hospital and Research Institute Rome Italy;Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences and Public Health University of Padua Padua Italy;EURObservational Research Programme European Society of Cardiology Sophia Antipolis France;First Department of Cardiology, School of Medicine in Katowice Medical University of Silesia 47 Ziołowa St. Katowice 40‐635 Poland;I.M. Sechenov First Moscow State Medical University (Sechenov University) Moscow Russia;Inherited Cardiac Diseases Unit, Barts Heart Centre St Bartholomew's Hospital and University College London (UCL) London UK;Maria Cecilia Hospital, GVM Care and Research Cotignola Italy;Mid‐German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care University Hospital Halle, Martin‐Luther‐University Halle‐Wittenberg Halle Germany;Russian National Research Medical University named after N.I. Pirogov Moscow Russia;San Camillo Hospital Rome Italy;San Raffaele Hospital Milan Italy;

关键词: Hypertrophic cardiomyopathy;    Dilated cardiomyopathy;    Restrictive cardiomyopathy;    Arrhythmogenic right ventricular cardiomyopathy;    Atrial fibrillation;    Anticoagulation;   

DOI  :  10.1002/ehf2.12854

来源: DOAJ

【 摘 要 】

Abstract 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.

【 授权许可】

Unknown