Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology. (17th September 2020)

• Record Type: Journal Article
• Authors: Mizia‐Stec, Katarzyna; Caforio, Alida L.P.; Charron, Philippe; Gimeno, Juan R.; Elliott, Perry; Kaski, Juan Pablo; Maggioni, Aldo P.; Tavazzi, Luigi; Rigopoulos, Angelos G.; Laroche, Cecile; Frigy, Attila; Zachara, Elisabetta; Pena‐Pena, Maria Luisa; Olusegun‐Joseph, Akinsanya; Pinto, Yigal; Sala, Simone; Drago, Fabrizio; Blagova, Olga; Reznik, Elena; Tendera, Michał
• Is Part Of: ESC heart failure. Volume 7:Number 6(2020)
• Page Start: 3601
• Page End: 3609
• Publication Date: 2020-09-17
• Subjects: Hypertrophic cardiomyopathy -- Dilated cardiomyopathy -- Restrictive cardiomyopathy -- Arrhythmogenic right ventricular cardiomyopathy -- Atrial fibrillation -- Anticoagulation; Heart failure -- Periodicals; 616.129005
• DOI: 10.1002/ehf2.12854
• Languages: English
• ISSNs: 2055-5822

Abstract

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.