Heart Failure Subtypes and Thromboembolic Risk in Patients with Atrial Fibrillation: The PREFER in AF - HF substudy

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F67985807%3A_____%2F18%3A00489777" target="_blank" >RIV/67985807:_____/18:00489777 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1016/j.ijcard.2018.04.093" target="_blank" >http://dx.doi.org/10.1016/j.ijcard.2018.04.093</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ijcard.2018.04.093" target="_blank" >10.1016/j.ijcard.2018.04.093</a>

Result language

angličtina

Original language name

Heart Failure Subtypes and Thromboembolic Risk in Patients with Atrial Fibrillation: The PREFER in AF - HF substudy

Original language description

BACKGROUND AND OBJECTIVES: To assess thromboembolic and bleeding risks in patients with heart failure (HF) and atrial fibrillation (AF) according to HF type. METHODS: We analyzed 6170 AF patients from the Prevention of thromboembolic events - European Registry in Atrial Fibrillation (PREFER in AF), and categorized patients into: HF with reduced left-ventricular ejection fraction (HFrEF, LVEF < 40%), mid-range EF (HFmrEF, LVEF: 40-49%), lower preserved EF (HFLpEF, LVEF: 50-60%), higher preserved EF (HFHpEF, LVEF > 60%), and no HF. Outcomes were ischemic stroke, major adverse cardiovascular and cerebral events (MACCE) and major bleeding occurring within 1-year. RESULTS: The annual incidence of stroke was linearly and inversely related to LVEF, increasing by 0.054% per each 1% of LVEF decrease (95% CI: 0.013%-0.096%, p = 0.031). Patients with HFHpEF had the highest CHA2DS2-VASc score, but significantly lower stroke incidence than other HF groups (0.65%, compared to HFLpEF 1.30%, HFmrEF 1.71%, HFrEF 1.75%, trend p = 0.014). The incidence of MACCE was also lower in HFHpEF (2.0%) compared to other HF groups (range: 3.8-4.4%, p = 0.001). Age, HF type, and NYHA class were independent predictors of thromboembolic events. Conversely, major bleeding did not significantly differ between groups (p = 0.168). CONCLUSION: Our study in predominantly anticoagulated patients with AF shows that, reduction in LVEF is associated with higher thromboembolic, but not higher bleeding risk. HFHpEF is a distinct and puzzling group, featuring the highest CHA2DS2-VASc score but the lowest residual risk of thromboembolic events, which warrants further investigation.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

International Journal of Cardiology

ISSN

0167-5273

e-ISSN

—

Volume of the periodical

265

Issue of the periodical within the volume

August

Country of publishing house

IE - IRELAND

Number of pages

7

Pages from-to

141-147

UT code for WoS article

000434679400031

EID of the result in the Scopus database

2-s2.0-85046126168