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Article

Relative Importance of Heart Failure Events Compared to Stroke and Bleeding in AF Patients

1
Institut Cœur Poumon, University of Lille, CHU Lille, 59000 Lille, France
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Hôpital Privé Le Bois, 59003 Lille, France
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Centre Hospitalier de Dunkerque, 59240 Dunkerque, France
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Institut Pasteur, U1167, Inserm, University of Lille, CHU Lille, 59000 Lille, France
*
Author to whom correspondence should be addressed.
Academic Editor: Katarzyna Mizia-Stec
J. Clin. Med. 2021, 10(5), 923; https://doi.org/10.3390/jcm10050923
Received: 28 January 2021 / Revised: 17 February 2021 / Accepted: 20 February 2021 / Published: 28 February 2021
(This article belongs to the Special Issue New Insights into Atrial Fibrillation)
Introduction: Incident heart failure (HF), ischemic stroke and systemic embolism (IS/SE), and major bleeding related to anticoagulation therapy are still the most frequent events occurring in patients with atrial fibrillation (AF). The aim of this study was to assess the 3-year incidence, predictors, and related mortality of IS/SE, major bleeding, and HF in a large cohort of AF outpatients. Methods and results: We studied 4973 outpatients with prevalent AF included in the CARDIONOR registry. The mean age was 72.9 ± 11.2 years, 24.1% had diabetes mellitus and 78.9% had anticoagulant therapy at baseline. The mean CHA2DS2Vasc score was 3.4 ± 1.7. After a median follow-up of 3.2 years (IQR: 2.8 to 3.5), incident HF, IS/SE and major bleeding occurred in 10.5%, 3.3% and 2.1% of patients, respectively. When analyzed as time-dependent variables, IS/SE, major bleeding and hospitalization for decompensated HF were all strongly associated with mortality. The independent predictors of incident HF were age, women, hypertension, diabetes mellitus, coronary artery disease and a previous history of HF. A sensitivity analysis in patients without history of HF at inclusion revealed that incident HF remained the most frequent adverse event, occurring in 5.3% of patients, compared to IS/SE (1.7%) and major bleeding (2.5%). Conclusion: HF is a common residual cardiovascular adverse event occurring in AF outpatients and is associated with a very high mortality. Since modifiable risk factors are associated with incident HF, upstream intensive management of these risk factors would be of interest. View Full-Text
Keywords: atrial fibrillation; heart failure; stroke; bleeding atrial fibrillation; heart failure; stroke; bleeding
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MDPI and ACS Style

Ninni, S.; Lemesle, G.; Meurice, T.; Tricot, O.; Lamblin, N.; Bauters, C. Relative Importance of Heart Failure Events Compared to Stroke and Bleeding in AF Patients. J. Clin. Med. 2021, 10, 923. https://doi.org/10.3390/jcm10050923

AMA Style

Ninni S, Lemesle G, Meurice T, Tricot O, Lamblin N, Bauters C. Relative Importance of Heart Failure Events Compared to Stroke and Bleeding in AF Patients. Journal of Clinical Medicine. 2021; 10(5):923. https://doi.org/10.3390/jcm10050923

Chicago/Turabian Style

Ninni, Sandro, Gilles Lemesle, Thibaud Meurice, Olivier Tricot, Nicolas Lamblin, and Christophe Bauters. 2021. "Relative Importance of Heart Failure Events Compared to Stroke and Bleeding in AF Patients" Journal of Clinical Medicine 10, no. 5: 923. https://doi.org/10.3390/jcm10050923

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