Causes of death of patients with non-valvular atrial fibrillation in Asians.

Krittayaphong, Rungroj ORCID: 0000-0001-8684-2361, Boonyapiphat, Thanita, Aroonsiriwattana, Suchart, Ngamjanyaporn, Pornchai and Lip, Gregory YH ORCID: 0000-0002-7566-1626 (2023) Causes of death of patients with non-valvular atrial fibrillation in Asians. PloS one, 18 (3). e0282455-.

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Abstract

<h4>Objectives</h4>The aim of this study was to determine the causes of death among Asian non-valvular atrial fibrillation (AF) patients who were registered in a nationwide AF registry, and to investigate the differences in the causes of death in AF patients compared between those who were taking and not taking oral anticoagulant (OAC).<h4>Methods</h4>The COhort of antithrombotic use and Optimal INR Level in patients with non-valvular Atrial Fibrillation in Thailand (COOL-AF) study enrolled non-valvular AF patients from 27 centers in Thailand during 2014-2017 to create the COOL-AF Thailand registry. Cause of death was classified as cardiovascular (CV) death, non-CV death, or undetermined cause of death. All events were evaluated and verified by an independent adjudication committee.<h4>Results</h4>There was a total of 3,405 patients (mean age: 67.8 years, 41.8% female), and the mean follow-up duration was 31.8±8.7 months. Three hundred and eighty patients (11.2%) died during follow-up. CV death, non-CV death, and undetermined cause accounted for 121 (31.8%), 189 (49.7%), and 70 (18.4%) patients, respectively. Of those with a known cause of death, heart failure (10%), intracranial hemorrhage (ICH; 10%), sudden cardiac death (6.8%), and ischemic stroke (5.8%) were the most often observed causes of death. Concerning non-CV death, infection/sepsis (27.7%), cancer (5.5%), respiratory (5.2%), and major bleeding (4.5%) were the most prevalent causes of death. The use and type of OAC were found to be major determinants of ICH and major bleeding incidence.<h4>Conclusion</h4>Death due to ischemic stroke was responsible for only 4.7% of all deaths in Asian AF patients. Non-CV death, such as infection/sepsis or malignancy, was more far more prevalent than CV death in Asian AF patients. An improved integrated care approach is needed to reduce the prevalence of non-CV death in Asian AF patients.

Item Type:	Article
Uncontrolled Keywords:	Humans, Atrial Fibrillation, Death, Sudden, Cardiac, Anticoagulants, Cause of Death, Aged, Female, Male, Ischemic Stroke, Asian
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	27 Sep 2023 10:20
Last Modified:	27 Sep 2023 10:20
DOI:	10.1371/journal.pone.0282455
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3173108