Prognosis of atrial fibrillation in patients with symptomatic peripheral arterial disease: data from the REduction of Atherothrombosis for Continued Health (REACH) Registry.

Abstract

BACKGROUND:

Atrial fibrillation (AF) is a significant risk factor for cardiovascular (CV) mortality. This study aims to evaluate the prognostic implication of AF in patients with peripheral arterial disease (PAD).

METHODS:

The International Reduction of Atherothrombosis for Continued Health (REACH) Registry included 23,542 outpatients in Europe with established coronary artery disease, cerebrovascular disease (CVD), PAD and/or > or =3 risk factors. Of these, 3753 patients had symptomatic PAD. CV risk factors were determined at baseline. Study end point was a combination of cardiac death, non-fatal myocardial infarction (MI) and stroke (CV events) during 2 years of follow-up. Cox regression analysis adjusted for age, gender and other risk factors (i.e., congestive heart failure, coronary artery re-vascularisation, coronary artery bypass grafting (CABG), MI, hypertension, stroke, current smoking and diabetes) was used.

RESULTS:

Of 3753 PAD patients, 392 (10%) were known to have AF. Patients with AF were older and had a higher prevalence of CVD, diabetes and hypertension. Long-term CV mortality occurred in 5.6% of patients with AF and in 1.6% of those without AF (p<0.001). Multivariable analyses showed that AF was an independent predictor of late CV events (hazard ratio (HR): 1.5; 95% confidence interval (CI): 1.09-2.0).

CONCLUSION:

AF is common in European patients with symptomatic PAD and is independently associated with a worse 2-year CV outcome.

• Authors: T A Winkel, S E Hoeks, O Schouten, U Zeymer, T Limbourg, I Baumgartner, D L Bhatt, Ph G Steg, S Goto, J Röther, P P Cacoub, H J M Verhagen, J J Bax, D Poldermans
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 40 Issue 1 Pg. 9-16 (Jul 2010) ISSN: 1532-2165 [Electronic] England
• PMID: 20385507 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Cardiovascular Agents

Topics

• Aged
• Aged, 80 and over
• Atrial Fibrillation (complications, drug therapy, mortality)
• Cardiovascular Agents (therapeutic use)
• Cardiovascular Diseases (etiology, mortality)
• Chi-Square Distribution
• Europe (epidemiology)
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (etiology, mortality)
• Outpatients
• Peripheral Vascular Diseases (complications, drug therapy, mortality)
• Prevalence
• Prognosis
• Proportional Hazards Models
• Prospective Studies
• Registries
• Risk Assessment
• Risk Factors
• Stroke (etiology, mortality)
• Time Factors