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Original Article| Volume 55, P28-34, September 2018

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Increased burden of comorbidities and risk of cardiovascular death in atrial fibrillation patients in Europe over ten years: A comparison between EORP-AF pilot and EHS-AF registries

Published:May 17, 2018DOI:https://doi.org/10.1016/j.ejim.2018.05.016
Increased burden of comorbidities and risk of cardiovascular death in atrial fibrillation patients in Europe over ten years: A comparison between EORP-AF pilot and EHS-AF registries
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      Highlights

      • •
        Temporal changes have been found in atrial fibrillation (AF) epidemiology.
      • •
        AF patients re becoming older and more burdened with comorbidities
      • •
        Use of oral anticoagulant (OAC) drugs increased over the last decade in Europe.
      • •
        OAC use is associated with a reduction in thromboembolic and cardiovascular events.
      • •
        Despite the increased OAC use, a high risk of cardiovascular death still persists.

      Abstract

      Background

      In 2002, the European Society of Cardiology conducted the Euro Heart Survey (EHS), while in 2014concluded 1-year follow-up of the EURObservational Research Programme AF (EORP-AF) Pilot Registry.

      Methods

      We analysed differences in clinical profiles, therapeutic approaches and outcomes between these two cohorts after propensity score matching (PSM).

      Results

      After PSM, 5206 patients were analysed. In EORP-AF there were more elderly patients than EHS (p < .001). EORP-AF patients were more burdened with cardiovascular (CV) and non-CV comorbidities, with a higher proportion of patients with high thromboembolic risk. EORP-AF patients used more oral-anticoagulant (OAC) (p < .001).
      At 1-year follow-up EORP-AF patients had lower risk for thromboembolic and CV events, readmission for AF and other CV reasons (all p < .001), showing conversely a higher risk for CV death (p = .015). Kaplan-Meier curves showed that EORP-AF patients had higher risk for CV death (p < .0001) and all-cause death (p = .0019). Cox regression confirmed that EORP-AF patients were at higher risk for CV death (p = .021).

      Conclusions

      We found significant changes in AF epidemiology over a decade in Europe, with older patients, more burdened with comorbidities. A greater use of OAC was found. Despite a reduction in risk for thromboembolic events, a high risk of CV-related death was still evident.

      Keywords

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      Article info

      Publication history

      Published online: May 17, 2018
      Accepted: May 9, 2018
      Received in revised form: April 13, 2018
      Received: February 6, 2018

      Identification

      DOI: https://doi.org/10.1016/j.ejim.2018.05.016

      Copyright

      © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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