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Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type
AIMS: This study aimed to elucidate the risk for stroke and systemic embolism (SE) in patients with atrial fibrillation and heart failure (HF) according to HF type. METHODS AND RESULTS: A total of 10 780 patients with atrial fibrillation were enrolled in a multicentre prospective registry and divide...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006674/ https://www.ncbi.nlm.nih.gov/pubmed/33634593 http://dx.doi.org/10.1002/ehf2.13264 |
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author | Uhm, Jae‐Sun Kim, Jun Yu, Hee Tae Kim, Tae‐Hoon Lee, So‐Ryoung Cha, Myung‐Jin Choi, Eue‐Keun Lee, Jung Myung Kim, Jin‐Bae Park, Junbeom Park, Jin‐Kyu Kang, Ki‐Woon Shim, Jaemin Park, Hyung Wook Lee, Young Soo Kim, Chang‐Soo Mun, Ji Eun Son, Nak‐Hoon Joung, Boyoung |
author_facet | Uhm, Jae‐Sun Kim, Jun Yu, Hee Tae Kim, Tae‐Hoon Lee, So‐Ryoung Cha, Myung‐Jin Choi, Eue‐Keun Lee, Jung Myung Kim, Jin‐Bae Park, Junbeom Park, Jin‐Kyu Kang, Ki‐Woon Shim, Jaemin Park, Hyung Wook Lee, Young Soo Kim, Chang‐Soo Mun, Ji Eun Son, Nak‐Hoon Joung, Boyoung |
author_sort | Uhm, Jae‐Sun |
collection | PubMed |
description | AIMS: This study aimed to elucidate the risk for stroke and systemic embolism (SE) in patients with atrial fibrillation and heart failure (HF) according to HF type. METHODS AND RESULTS: A total of 10 780 patients with atrial fibrillation were enrolled in a multicentre prospective registry and divided according to HF type: no‐HF, HF with preserved ejection fraction (EF) (HFpEF), HF with mid‐range EF (HFmrEF), and HF with reduced EF (HFrEF). Each group included 237 age‐matched and sex‐matched patients (age, 69.0 ± 10.3 years; men, 69.6%). The baseline characteristics, cumulative incidence, and hazard ratios for stroke/SE and major bleeding were compared across the groups. Patients with HF accounted for 10.3% of the total population; HFpEF, HFmrEF, and HFrEF represented 43.7%, 23.6%, and 32.7% of the patients with HF, respectively. The CHA(2)DS(2)‐VASc score was significantly higher in the HFpEF, HFmrEF, and HFrEF groups than in the no‐HF group. The annual stroke/SE incidence rates were 2.8%, 0.7%, 1.1%, and 0.9% in the HFpEF, HFmrEF, HFrEF, and no‐HF groups, respectively. The cumulative incidence of stroke/SE was significantly highest in the HFpEF group at 22.8 ± 10.0 months (P = 0.020). The stroke/SE risk was higher in the HFpEF group than in the HFmrEF and HFrEF groups (hazard ratio, 3.192; 95% confidence interval, 1.039–9.810; P = 0.043). E/e' value was an independent risk factor for stroke/SE. There were no significant differences in the incidence of major bleeding across the groups. CONCLUSIONS: The stroke/SE risk was the highest in the HFpEF group and comparable between the HFmrEF and HFrEF groups. |
format | Online Article Text |
id | pubmed-8006674 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80066742021-04-01 Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type Uhm, Jae‐Sun Kim, Jun Yu, Hee Tae Kim, Tae‐Hoon Lee, So‐Ryoung Cha, Myung‐Jin Choi, Eue‐Keun Lee, Jung Myung Kim, Jin‐Bae Park, Junbeom Park, Jin‐Kyu Kang, Ki‐Woon Shim, Jaemin Park, Hyung Wook Lee, Young Soo Kim, Chang‐Soo Mun, Ji Eun Son, Nak‐Hoon Joung, Boyoung ESC Heart Fail Original Research Articles AIMS: This study aimed to elucidate the risk for stroke and systemic embolism (SE) in patients with atrial fibrillation and heart failure (HF) according to HF type. METHODS AND RESULTS: A total of 10 780 patients with atrial fibrillation were enrolled in a multicentre prospective registry and divided according to HF type: no‐HF, HF with preserved ejection fraction (EF) (HFpEF), HF with mid‐range EF (HFmrEF), and HF with reduced EF (HFrEF). Each group included 237 age‐matched and sex‐matched patients (age, 69.0 ± 10.3 years; men, 69.6%). The baseline characteristics, cumulative incidence, and hazard ratios for stroke/SE and major bleeding were compared across the groups. Patients with HF accounted for 10.3% of the total population; HFpEF, HFmrEF, and HFrEF represented 43.7%, 23.6%, and 32.7% of the patients with HF, respectively. The CHA(2)DS(2)‐VASc score was significantly higher in the HFpEF, HFmrEF, and HFrEF groups than in the no‐HF group. The annual stroke/SE incidence rates were 2.8%, 0.7%, 1.1%, and 0.9% in the HFpEF, HFmrEF, HFrEF, and no‐HF groups, respectively. The cumulative incidence of stroke/SE was significantly highest in the HFpEF group at 22.8 ± 10.0 months (P = 0.020). The stroke/SE risk was higher in the HFpEF group than in the HFmrEF and HFrEF groups (hazard ratio, 3.192; 95% confidence interval, 1.039–9.810; P = 0.043). E/e' value was an independent risk factor for stroke/SE. There were no significant differences in the incidence of major bleeding across the groups. CONCLUSIONS: The stroke/SE risk was the highest in the HFpEF group and comparable between the HFmrEF and HFrEF groups. John Wiley and Sons Inc. 2021-02-25 /pmc/articles/PMC8006674/ /pubmed/33634593 http://dx.doi.org/10.1002/ehf2.13264 Text en © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Articles Uhm, Jae‐Sun Kim, Jun Yu, Hee Tae Kim, Tae‐Hoon Lee, So‐Ryoung Cha, Myung‐Jin Choi, Eue‐Keun Lee, Jung Myung Kim, Jin‐Bae Park, Junbeom Park, Jin‐Kyu Kang, Ki‐Woon Shim, Jaemin Park, Hyung Wook Lee, Young Soo Kim, Chang‐Soo Mun, Ji Eun Son, Nak‐Hoon Joung, Boyoung Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
title | Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
title_full | Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
title_fullStr | Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
title_full_unstemmed | Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
title_short | Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
title_sort | stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006674/ https://www.ncbi.nlm.nih.gov/pubmed/33634593 http://dx.doi.org/10.1002/ehf2.13264 |
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