Highlights
- •The BLITZ-AF has a high 1-year mortality rate due to heart failure.
- •Thromboembolic and hemorrhagic events were few at 1 year follow-up.
- •Persistence on oral anticoagulant therapy at 1 year was high.
- •The increase in prescription of DOACs contributes to the persistence of treatment.
Structured abstract
Background
The management of atrial fibrillation (AF) has changed with the introduction of direct
anticoagulants (DOACs) and new techniques such as catheter ablation. An update collection
of data from “real world” AF patients followed by cardiologists is useful to obtain
information on both management, outcomes and guideline adherence in clinical practice.
Methods
Follow-up information on survival, embolic and bleeding events and hospital readmission,
persistence of oral anticoagulant (OAC) therapy was collected in 84 centers participating
to the BLITZ-AF study.
Results
Patients were followed for a median of 366 days (IQR: 356–378) and vital status was
available for 2159 patients. Mortality was 9.2%. Heart failure was the most common
cardiovascular cause of death (70%) followed by arrhythmias (6.7%), acute coronary
syndrome (5.0%) and ischemic stroke (2.5%). During follow-up 18.1% of the patients
were readmitted, mainly (81.3%) for cardiovascular causes. Patients on OAC were 83.4%,
9.1% were on antiplatelets and 7.5% did not receive antithrombotic therapy. The use
of DOACs increased from 42.1% to 46.4% during the follow-up, OAC discontinuation occurred
in 9.1%. AF recurrences occurred in 23.4% of the patients discharged in sinus rhythm.
Rate control strategy was adopted in 55.9% and beta-blockers were the most used drugs
(81.9%). Amiodarone (22%) and flecainide (9.7%) were the most frequent used antiahrrythmic
drugs.
Conclusions
The follow-up of the BLITZ-AF study provide an up to date picture of the clinical
course of patients with AF, who appear frequently affected by heart failure and severe
comorbidities which might have led to the high mortality rate.
Keywords
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Article info
Publication history
Published online: January 14, 2020
Accepted:
December 15,
2019
Received in revised form:
December 11,
2019
Received:
July 23,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
