Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes: real-world data from the FANTASIIA Registry
Por:
García-Fernández A, Esteve-Pastor MA, Rabadán IR, Muñiz J, Ruiz Ortiz M, Cequier Á, Bertomeu-Martínez V, Badimón L, Otero D, Anguita M, Lip GYH and Marín F
Publicada:
17 ago 2020
Ahead of Print:
1 jun 2020
Categoría:
Medicine (miscellaneous)
Resumen:
Background:Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose:To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods:AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated. Results:1956 patients (mean age 73.8 +/- 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%;p < .001) or renal disease (21.4% vs 15.9%;p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year;p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year;p < .001) and MACE (12.9%/year vs 6.8%/year;p < .001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 +/- 24.37% vs 62.68 +/- 25.31%;p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80);p = .024]. Conclusion:AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk.
Filiaciones:
García-Fernández A:
Department of Cardiology, Alicante General University Hospital, Sanitary and Biomedical Investigation Institute of Alicante (ISABIAL-FISABIO), Spain
Esteve-Pastor MA:
Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, Murcia, Spain
Rabadán IR:
Department of Cardiology, University Hospital La Paz, Madrid, Spain
Muñiz J:
Instituto Universitario de Ciencias de la Salud de la Universidad de A Coruña
Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, Spain
Ruiz Ortiz M:
Department of Cardiology, University Hospital Reina Sofia, Cordoba, Spain
Cequier Á:
Department of Cardiology, University Hospital of Bellvitge, CIBERCV, Barcelona, Spain
:
Department of Cardiology, University Hospital San Juan de Alicante, Alicante, Spain
Badimón L:
Cardiovascular Research Centre(CSIC-ICCC), CIBERCV, Barcelona, Spain
Otero D:
ODDS, S.L., A Coruña, Spain
Anguita M:
Department of Cardiology, University Hospital Reina Sofia, Cordoba, Spain
Lip GYH:
Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark
Marín F:
Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, Murcia, Spain
Green Published, Bronze
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