Association between antithrombotic treatment and outcomes at 1-year follow-up in patients with atrial fibrillation: the EORP-AF General Long-Term Registry


Boriani, Giuseppe, Proietti, Marco ORCID: 0000-0003-1452-2478, Laroche, Cecile, Fauchier, Laurent, Marin, Francisco, Nabauer, Michael, Potpara, Tatjana, Dan, Gheorghe-Andrei, Kalarus, Zbigniew, Tavazzi, Luigi et al (show 2 more authors) (2019) Association between antithrombotic treatment and outcomes at 1-year follow-up in patients with atrial fibrillation: the EORP-AF General Long-Term Registry. EUROPACE, 21 (7). pp. 1013-1022.

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Abstract

<h4>Aims</h4>In recent years, stroke prevention in patients with atrial fibrillation (AF) has radically changed, with increasing use of non-vitamin K antagonist oral anticoagulants (NOACs). Contemporary European data on AF thromboprophylaxis are needed.<h4>Methods and results</h4>We report 1-year follow-up data from the EURObservational Research Programme in Atrial Fibrillation (EORP-AF) General Long-Term Registry. Outcomes were assessed according to antithrombotic therapy. At 1-year follow-up, 9663 (88.0%) patients had available data for analysis: 586 (6.1%) were not treated with any antithrombotic; 681 (7.0%) with antiplatelets only; 4066 (42.1%) with vitamin K antagonist (VKA) only; 3167 (32.8%) with NOACs only; and 1163 (12.0%) with antiplatelet and oral anticoagulant. At 1-year follow-up, there was a low rate of stroke (0.7%) and any thromboembolic event (TE) (1.2%), while haemorrhagic events occurred in 222 patients (2.3%). Cardiovascular (CV) death and all-cause death occurred in 3.9% and 5.2% of patients, respectively. Cumulative survival for all the three main outcomes considered was highest amongst patients treated only with NOACs (P < 0.0001). Multivariable-adjusted Cox regression analysis found that VKA or NOACs use was independently associated with a lower risk for any TE/acute coronary syndrome/CV death, while all treatments were independently associated with a lower risk for CV death and all-cause death.<h4>Conclusion</h4>The 1-year follow-up of EORP-AF General Long-Term Registry reported a low occurrence of thromboembolic and haemorrhagic events, although mortality was high. Both VKA and NOACs were associated with a lower risk of all main adverse outcomes. All treatments were associated with a lower risk for CV death and all-cause death.

Item Type: Article
Uncontrolled Keywords: Atrial fibrillation, Stroke, Antithrombotic therapy, Observational registries, Outcomes, EORP-AF registry
Depositing User: Symplectic Admin
Date Deposited: 10 Apr 2019 09:56
Last Modified: 19 Jan 2023 00:54
DOI: 10.1093/europace/euz032
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3036344
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