ESC Heart Failure (Dec 2020)

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

  • Katarzyna Mizia‐Stec,
  • Alida L.P. Caforio,
  • Philippe Charron,
  • Juan R. Gimeno,
  • Perry Elliott,
  • Juan Pablo Kaski,
  • Aldo P. Maggioni,
  • Luigi Tavazzi,
  • Angelos G. Rigopoulos,
  • Cecile Laroche,
  • Attila Frigy,
  • Elisabetta Zachara,
  • Maria Luisa Pena‐Pena,
  • Akinsanya Olusegun‐Joseph,
  • Yigal Pinto,
  • Simone Sala,
  • Fabrizio Drago,
  • Olga Blagova,
  • Elena Reznik,
  • Michał Tendera

DOI
https://doi.org/10.1002/ehf2.12854
Journal volume & issue
Vol. 7, no. 6
pp. 3601 – 3609

Abstract

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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.

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