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Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy

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Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy. / Siller-Matula, Jolanta M; Pecen, Ladislav; Patti, Giuseppe; Lucerna, Markus; Kirchhof, Paulus; Lesiak, Maciej; Huber, Kurt; Verheugt, Freek W A; Lang, Irene M; Renda, Giulia; Schnabel, Renate B; Wachter, Rolf; Kotecha, Dipak; Sellal, Jean-Marc; Rohla, Miklos; Ricci, Fabrizio; De Caterina, Raffaele; TEAM in AF group.

in: INT J CARDIOL, Jahrgang 265, 15.08.2018, S. 141-147.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Siller-Matula, JM, Pecen, L, Patti, G, Lucerna, M, Kirchhof, P, Lesiak, M, Huber, K, Verheugt, FWA, Lang, IM, Renda, G, Schnabel, RB, Wachter, R, Kotecha, D, Sellal, J-M, Rohla, M, Ricci, F, De Caterina, R & TEAM in AF group 2018, 'Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy', INT J CARDIOL, Jg. 265, S. 141-147. https://doi.org/10.1016/j.ijcard.2018.04.093

APA

Siller-Matula, J. M., Pecen, L., Patti, G., Lucerna, M., Kirchhof, P., Lesiak, M., Huber, K., Verheugt, F. W. A., Lang, I. M., Renda, G., Schnabel, R. B., Wachter, R., Kotecha, D., Sellal, J-M., Rohla, M., Ricci, F., De Caterina, R., & TEAM in AF group (2018). Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy. INT J CARDIOL, 265, 141-147. https://doi.org/10.1016/j.ijcard.2018.04.093

Vancouver

Siller-Matula JM, Pecen L, Patti G, Lucerna M, Kirchhof P, Lesiak M et al. Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy. INT J CARDIOL. 2018 Aug 15;265:141-147. https://doi.org/10.1016/j.ijcard.2018.04.093

Bibtex

@article{bcfd9d9cf0434887956e3222c5f7df66,
title = "Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy",
abstract = "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.",
keywords = "Aged, Anticoagulants/adverse effects, Atrial Fibrillation/diagnosis, Cohort Studies, Europe/epidemiology, Female, Follow-Up Studies, Heart Failure/diagnosis, Hemorrhage/chemically induced, Humans, Male, Prospective Studies, Registries, Risk Factors, Stroke/diagnosis, Stroke Volume/drug effects, Thromboembolism/diagnosis",
author = "Siller-Matula, {Jolanta M} and Ladislav Pecen and Giuseppe Patti and Markus Lucerna and Paulus Kirchhof and Maciej Lesiak and Kurt Huber and Verheugt, {Freek W A} and Lang, {Irene M} and Giulia Renda and Schnabel, {Renate B} and Rolf Wachter and Dipak Kotecha and Jean-Marc Sellal and Miklos Rohla and Fabrizio Ricci and {De Caterina}, Raffaele and {TEAM in AF group}",
note = "Copyright {\textcopyright} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
month = aug,
day = "15",
doi = "10.1016/j.ijcard.2018.04.093",
language = "English",
volume = "265",
pages = "141--147",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Heart failure subtypes and thromboembolic risk in patients with atrial fibrillation: The PREFER in AF - HF substudy

AU - Siller-Matula, Jolanta M

AU - Pecen, Ladislav

AU - Patti, Giuseppe

AU - Lucerna, Markus

AU - Kirchhof, Paulus

AU - Lesiak, Maciej

AU - Huber, Kurt

AU - Verheugt, Freek W A

AU - Lang, Irene M

AU - Renda, Giulia

AU - Schnabel, Renate B

AU - Wachter, Rolf

AU - Kotecha, Dipak

AU - Sellal, Jean-Marc

AU - Rohla, Miklos

AU - Ricci, Fabrizio

AU - De Caterina, Raffaele

AU - TEAM in AF group

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/8/15

Y1 - 2018/8/15

N2 - 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.

AB - 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.

KW - Aged

KW - Anticoagulants/adverse effects

KW - Atrial Fibrillation/diagnosis

KW - Cohort Studies

KW - Europe/epidemiology

KW - Female

KW - Follow-Up Studies

KW - Heart Failure/diagnosis

KW - Hemorrhage/chemically induced

KW - Humans

KW - Male

KW - Prospective Studies

KW - Registries

KW - Risk Factors

KW - Stroke/diagnosis

KW - Stroke Volume/drug effects

KW - Thromboembolism/diagnosis

U2 - 10.1016/j.ijcard.2018.04.093

DO - 10.1016/j.ijcard.2018.04.093

M3 - SCORING: Journal article

C2 - 29706429

VL - 265

SP - 141

EP - 147

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

ER -