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Abstract
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.
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Details
1 First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
2 Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
3 Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique‐Hôpitaux de Paris, ICAN, Hôpital Pitié‐Salpêtrière, Paris, France; Sorbonne Université, INSERM UMR1166, Paris, France
4 Cardiac Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
5 Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew's Hospital and University College London (UCL), London, UK
6 Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London, UK
7 EURObservational Research Programme, European Society of Cardiology, Sophia Antipolis, France; ANMCO Research Center, Florence, Italy
8 Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy
9 Mid‐German Heart Center, Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin‐Luther‐University Halle‐Wittenberg, Halle, Germany
10 EURObservational Research Programme, European Society of Cardiology, Sophia Antipolis, France
11 Clinical County Hospital, Târgu Mureș, Romania
12 San Camillo Hospital, Rome, Italy
13 Cardiac Imaging and Inherited Cardiac Diseases Unit, Department of Cardiology, Virgen del Rocio University Hospital, Seville, Spain
14 Cardiology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
15 Academic Medical Center, Amsterdam, The Netherlands
16 San Raffaele Hospital, Milan, Italy
17 Department of Pediatric Cardiology, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy
18 I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
19 Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia
20 Department of Cardiology and Structural Heart Disease, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland