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Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry
Author(s) -
BertomeuGonzalez Vicente,
MorenoArribas José,
EstevePastor María Asunción,
RoldánRabadán Inmaculada,
Muñiz Javier,
Otero García Déborah,
RuizOrtiz Martín,
Cequier Ángel,
BertomeuMartínez Vicente,
Badimón Lina,
Anguita Manuel,
Lip Gregory Y. H.,
Marín Francisco
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13431
Subject(s) - medicine , mace , atrial fibrillation , myocardial infarction , stroke (engine) , cardiology , cohort , coronary artery disease , univariate analysis , cohort study , surgery , multivariate analysis , conventional pci , mechanical engineering , engineering
Background Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF. Methods We prospectively included 1956 patients (mean age 73.8 ± 9.5 years, 44.0% women) receiving oral anticoagulant therapy for AF. Clinical characteristics were collected at baseline. Patients were followed for a period of 3 years. Survival analysis and multivariable regression analyses were performed to assess variables related to death, stroke, bleeding, myocardial infarction and major adverse cardiovascular events (MACE). Results Patients with PAD (n = 118; 6%) exhibited higher rates of cardiovascular risk factors and cardiovascular diseases. After 3 years of follow‐up, there were a total of 255 deaths (no PAD 233, vs PAD 22), 45 strokes (43 vs 2), 146 major bleedings (136 vs 10) and 168 MACE (148 vs 20). On univariate analysis, there was a higher risk of cardiovascular mortality (2.02%/year no PAD vs 4.08%/year PAD, P = .02), myocardial infarction (0.99%/year no PAD vs 2.43%/year PAD, P = .02) and MACE (3.18%/year no PAD vs 6.99%/year PAD, P < .01). There was no statistically significant association with these events after multivariable adjustment. Conclusions In a large cohort of anticoagulated patients with AF, the presence of PAD represents a higher risk subgroup and is associated with worse crude outcomes. The exact contribution of the PAD independently of other cardiovascular diseases or risk factors requires further investigation.