Clinical characteristics and thromboembolic risk of atrial fibrillation patients with and without congestive heart failure. Results from the CRATF study.

Abstract

Congestive heart failure (CHF) and atrial fibrillation (AF) frequently coexist and are associated with increased risk of cardiovascular events.To compare baseline characteristics, comorbidities and pharmacotherapy in AF patients with concomitant CHF to those without CHF.The study included 3506 real-life AF patients with (37.1%) and without CHF - participants of the multicentre, retrospective MultiCenter expeRience in AFib patients Treated with OAC (CRAFT) trial (NCT02987062).All patients were treated with non-vitamin K antagonist oral anticoagulants (NOAC) or vitamin K antagonists (VKA). The frequency of NOAC among patients with and without CHF was 45.6% and 43.2%, respectively (P = .17). Patients with CHF were older (73.3 vs 64.7 years, P <.001), less likely to be women (37.4% vs 42%, P = .007), had higher CHA2DS2-VASc score (3.8 ± 1.7 vs 2.6 ± 1.8, P <.001), more often had permanent AF (53.0% vs 13.4%, P <.001), chronic obstructive pulmonary disease (16.7% vs 4.9%, P <.001), coronary artery disease (64.3% vs 29.8%, P <.001), peripheral vascular disease (65.3% vs 31.4%, P <.001), chronic kidney disease (43.1% vs 10.0%, P <.001), liver fibrosis (5.7% vs 2.6%, P <.001), neoplasm (9.6% vs 7.3%, P = .05), history of composite of stroke, transient ischemic attack or systemic embolization (16.2% vs 10.7%, P <.001), pacemaker (27.4% vs 22.1%, P = .004), implantable cardioverter-defibrillator (22.7% vs 0.8%, P <.001) or transaortic valve implantation (4.0% vs 0.8%, P <.001), cardiac resynchronization therapy (8.7% vs 0.3%, P <.001), composite of kidney transplantation, hemodialysis or creatinine level > 2.26 mg/dL (3.6% vs 0.8%, P <.001) and had less often hypertension (69.4% vs 72.5%, P = .05).Patients with AF and CHF had a higher thromboembolic risk and had more concomitant diseases.

• Authors: Paweł Balsam, Monika Gawałko, Michał Peller, Agata Tymińska, Krzysztof Ozierański, Martyna Zaleska, Katarzyna Żukowska, Katarzyna Szepietowska, Kacper Maciejewski, Marcin Grabowski, Mariusz Borkowski, Łukasz Kołtowski, Anna Praska-Oginska, Inna Zaboyska, Grzegorz Opolski, Janusz Bednarski
• Journal: Medicine (Medicine (Baltimore)) Vol. 97 Issue 45 Pg. e13074 (Nov 2018) ISSN: 1536-5964 [Electronic] United States
• PMID: 30407304 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Chemical References

• Anticoagulants

Topics

• Aged
• Aged, 80 and over
• Anticoagulants (therapeutic use)
• Atrial Fibrillation (complications)
• Comorbidity
• Female
• Heart Failure (complications)
• Humans
• Incidence
• Male
• Retrospective Studies
• Risk Factors
• Thromboembolism (epidemiology, etiology, prevention & control)