Open AccessAtrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology
Author(s) -
MiziaStec 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,
PenaPena Maria Luisa,
OlusegunJoseph Akinsanya,
Pinto Yigal,
Sala Simone,
Drago Fabrizio,
Blagova Olga,
Reznik Elena,
Tendera Michał
Publication year - 2020
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12854
Subject(s) - medicine , atrial fibrillation , cardiology , heart failure , stroke (engine) , vitamin k antagonist , cardiomyopathy , odds ratio , myocarditis , incidence (geometry) , warfarin , mechanical engineering , engineering , physics , optics
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.