Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type
- 주제(키워드) Atrial fibrillation , Bleeding , Ejection fraction , Heart failure , Stroke , Systemic embolism
- 후원정보 Uhm, J.-S.; Division of Cardiology, 50-1 Yonsei-ro Seodaemun-gu, South Korea; email: jason@yuhs.ac Joung, B.; Division of Cardiology, 50-1 Yonsei-ro Seodaemun-gu, South Korea; email: cby6908@yuhs.ac
- 등재 SCIE, SCOPUS
- 발행기관 John Wiley and Sons Inc
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000181678
- 본문언어 영어
- Published As http://dx.doi.org/10.1002/ehf2.13264
초록/요약
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 CHA2DS2-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. © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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