Abstract:
BACKGROUND:The EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot) provides systematic collection of contemporary data regarding the management and treatment of 3119 subjects with AF from 9 member European Society of Cardiology (ESC) countries. In this analysis, we report the development of symptoms, use of antithrombotic therapy and rate vs. rhythm strategies, as well as determinants of mortality and/or stroke/transient ischaemic attack (TIA)/peripheral embolism during 1-year follow-up in this contemporary European registry of AF patients. METHODS:The registry population comprised consecutive in- and out-patients with AF presenting to cardiologists in participating ESC countries. Consecutive patients with AF documented by ECG were enrolled. Follow-up was performed by the local investigator, initially at 1 year, as part of a long-term cohort study. RESULTS:At the follow-up, patients were frequently asymptomatic (76.8%), but symptoms are nevertheless common among paroxysmal and persistent AF patients, especially palpitations, fatigue, and shortness of breath. Oral anticoagulant (OAC) use remains high, ∼78% overall at follow-up, and of those on vitamin K antagonist (VKA), 84% remained on VKA during the follow-up, while of those on non-VKA oral anticoagulant (NOAC) at baseline, 86% remained on NOAC, and 11.8% had changed to a VKA and 1.1% to antiplatelet therapy. Digitalis was commonly used in paroxysmal AF patients. Of rhythm control interventions, electrical cardioversion was performed in 9.7%, pharmacological cardioversion in 5.1%, and catheter ablation in 4.4%. Despite good adherence to anticoagulation, 1-year mortality was high (5.7%), with most deaths were cardiovascular (70%). Hospital readmissions were common, especially for atrial tachyarrhythmias and heart failure. On multivariate analysis, independent baseline predictors for mortality and/or stroke/TIA/peripheral embolism were age, AF as primary presentation, previous TIA, chronic kidney disease, chronic heart failure, malignancy, and minor bleeding. Independent predictors of mortality were age, chronic kidney disease, AF as primary presentation, prior TIA, chronic obstructive pulmonary disease, malignancy, minor bleeding, and diuretic use. Statin use was predictive of lower mortality. CONCLUSION:In this 1-year follow-up analysis of the EORP-AF pilot general registry, we provide data on the first contemporary registry focused on management practices among European cardiologists, conducted since the publication of the new ESC guidelines. Overall OAC use remains high, although persistence with therapy may be problematic. Nonetheless, continued OAC use was more common than in prior reports. Despite the high prescription of OAC, 1-year mortality and morbidity remain high in AF patients, particularly from heart failure and hospitalizations.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Lip GY,Laroche C,Ioachim PM,Rasmussen LH,Vitali-Serdoz L,Petrescu L,Darabantiu D,Crijns HJ,Kirchhof P,Vardas P,Tavazzi L,Maggioni AP,Boriani Gdoi
10.1093/eurheartj/ehu374subject
Has Abstractpub_date
2014-12-14 00:00:00pages
3365-76issue
47eissn
0195-668Xissn
1522-9645pii
ehu374journal_volume
35pub_type
杂志文章,多中心研究abstract::Left ventricular performance at rest and during supine symptom-limited exercise was determined by radionuclide ventriculography (RNV) in 65 subjects of the age of 65 years or older. Eleven subjects had no evidence of coronary artery disease (CAD) by history or submaximal stress ECG. In this control group left ventricu...
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更新日期:1984-11-01 00:00:00
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journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a060375
更新日期:1994-01-01 00:00:00
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journal_title:European heart journal
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doi:10.1093/eurheartj/ehm262
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journal_title:European heart journal
pub_type: 临床试验,杂志文章
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更新日期:1987-07-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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doi:10.1093/oxfordjournals.eurheartj.a014795
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