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Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type

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Abstract
Aims: This study aimed to elucidate the risk for stroke and systemic embolism (SE) in patients with atrial fibrillation and heart failure (HF) according to HF type.

Methods and results: A total of 10 780 patients with atrial fibrillation were enrolled in a multicentre prospective registry and divided according to HF type: no-HF, HF with preserved ejection fraction (EF) (HFpEF), HF with mid-range EF (HFmrEF), and HF with reduced EF (HFrEF). Each group included 237 age-matched and sex-matched patients (age, 69.0 +/- 10.3 years; men, 69.6%). The baseline characteristics, cumulative incidence, and hazard ratios for stroke/SE and major bleeding were compared across the groups. Patients with HF accounted for 10.3% of the total population; HFpEF, HFmrEF, and HFrEF represented 43.7%, 23.6%, and 32.7% of the patients with HF, respectively. The CHA(2)DS(2)-VASc score was significantly higher in the HFpEF, HFmrEF, and HFrEF groups than in the no-HF group. The annual stroke/SE incidence rates were 2.8%, 0.7%, 1.1%, and 0.9% in the HFpEF, HFmrEF, HFrEF, and no-HF groups, respectively. The cumulative incidence of stroke/SE was significantly highest in the HFpEF group at 22.8 +/- 10.0 months (P = 0.020). The stroke/SE risk was higher in the HFpEF group than in the HFmrEF and HFrEF groups (hazard ratio, 3.192; 95% confidence interval, 1.039-9.810; P = 0.043). E/e' value was an independent risk factor for stroke/SE. There were no significant differences in the incidence of major bleeding across the groups.

Conclusions: The stroke/SE risk was the highest in the HFpEF group and comparable between the HFmrEF and HFrEF groups.
Author(s)
강기원김준김진배김창수김태순문지은박준범박진규박형욱손낙훈심재민엄재선유희태이수영이영수이정명정보영차명진최의근
Issued Date
2021
Type
Article
Keyword
AgeAnticoagulantsAtrial fibrillationBleedingCardiac arrhythmiaCardiovascular diseaseDiabetesEjection fractionEmbolismsHeart failureHemoglovinHypertensionPeptidesPopulationRegression analysisRisk factorsStandard deviationStrokeSystemic embolismTransient ischemic attack
DOI
10.1002/ehf2.13264
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7220
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_19948e86ef45400f978142c20c954091&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Stroke%20and%20systemic%20embolism%20in%20patients%20with%20atrial%20fibrillation%20and%20heart%20failure%20according%20to%20heart%20failure%20type&sortby=rank
Publisher
ESC HEART FAILURE
Location
미국
Language
영어
ISSN
2055-5822
Citation Volume
8
Citation Number
2
Citation Start Page
1582
Citation End Page
1589
Appears in Collections:
Medicine > Medicine
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