Abstract

BACKGROUND: The aim of this study was to analyze the impact of the presence of heart failure (HF) on the clinical profile and outcomes in patients with atrial fibrillation (AF) anticoagulated with rivaroxaban.
METHODS: Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before inclusion. Data were analyzed according to baseline HF status.
RESULTS: Out of 1,433 patients, 326 (22.7%) had HF at baseline. Compared to patients without HF, HF patients were older (75.3 ± 9.9 vs. 73.8 ± 9.6 years; p = 0.01), had more diabetes (36.5% vs. 24.3%; p < 0.01), coronary artery disease (28.2% vs. 12.9%; p < 0.01), renal insufficiency (31.7% vs. 22.6%; p = 0.01), higher CHA2DS2-VASc (4.5 ± 1.6 vs. 3.2 ± 1.4; p < 0.01) and HAS-BLED (1.8 ± 1.1 vs. 1.5 ± 1.0; p < 0.01). After a median follow-up of 2.5 years, among HF patients, annual rates of stroke/systemic embolism/transient ischemic attack, major adverse cardiovascular events (MACE) (non-fatal myocardial infarction, revascularization and cardiovascular death), cardiovascular death, and major bleeding were 1.2%, 3.0%, 2.0%, and 1.4%, respectively. Compared to those patients without HF, HF patients had greater annual rates of MACE (3.0% vs. 0.5%; p < 0.01) and cardiovascular death (2.0% vs. 0.2%; p < 0.01), without significant differences regarding other outcomes, including thromboembolic or bleeding events. Previous HF was an independent predictor of MACE (odds ratio 3.4; 95% confidence interval 1.6–7.3; p = 0.002) but not for thromboembolic events or major bleeding.
CONCLUSIONS: Among AF patients anticoagulated with rivaroxaban, HF patients had a worse clinical profile and a higher MACE risk and cardiovascular mortality. HF was independently associated with the development of MACE, but not with thromboembolic events or major bleeding.

Details

Title
Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study
Author
Anguita Sánchez, Manuel 1 ; Marín, Francisco 2 ; Masjuan, Jaime 3 ; Cosín-Sales, Juan 4 ; Vázquez Rodríguez, José Manuel 5 ; Barrios, Vivencio 6 ; Barón-Esquivias, Gonzalo 7 ; Lekuona, Iñaki 8 ; Pérez-Cabeza, Alejandro I. 9 ; Freixa-Pamias, Román 10 ; Parra Jimenez, Francisco Javier 11 ; Monzer Khanji Khatib, Mohamed 12 ; Rafols Priu, Carles 13 ; Sanmartín Fernández, Marcelo 14 

 Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, Spain. [email protected] 
 Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain 
 Servicio de Neurología, Hospital Universitario Ramón y Cajal, IRYCIS, Departamento de Medicina, Universidad de Alcalá. Red INVICTUS, Madrid, Spain 
 Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain 
 Department of Cardiology, Complejo Hospitalario Universitario A Coruña, INIBIC, CIBERCV, A Coruña, Spain 
 Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Alcalá University, Madrid, Spain 
 Department of Cardiology, Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain 
 Hospital Galdakao-Usansolo, Bizkaia, Spain 
 Department of Cardiology, Hospital Virgen de la Victoria, CIBERCV, Málaga, Spain 
10  Department of Cardiology, Hospital Moisés Broggi, Barcelona, Spain 
11  Department of Cardiology, Centro Integral de Enfermedades Cardiovasculares, HM Hospitales, Madrid, Spain 
12  Department of Cardiology, Clínica LAMAR, Tomelloso (Ciudad Real), Spain 
13  Department of Medical Affairs, Bayer Hispania, Barcelona, Spain 
14  Department of Cardiology, Hospital Universitario Ramon y Cajal, Madrid, Spain 
First page
936
End page
947
Publication year
2022
Publication date
2022
Publisher
Wydawnictwo Via Medica
ISSN
18975593
e-ISSN
1898018X
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2756056726
Copyright
© 2022. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.