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Causes of death of patients with non-valvular atrial fibrillation in Asians

OBJECTIVES: The aim of this study was to determine the causes of death among Asian non-valvular atrial fibrillation (AF) patients who were registered in a nationwide AF registry, and to investigate the differences in the causes of death in AF patients compared between those who were taking and not t...

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Autores principales: Krittayaphong, Rungroj, Boonyapiphat, Thanita, Aroonsiriwattana, Suchart, Ngamjanyaporn, Pornchai, Lip, Gregory Y. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977019/
https://www.ncbi.nlm.nih.gov/pubmed/36857361
http://dx.doi.org/10.1371/journal.pone.0282455
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author Krittayaphong, Rungroj
Boonyapiphat, Thanita
Aroonsiriwattana, Suchart
Ngamjanyaporn, Pornchai
Lip, Gregory Y. H.
author_facet Krittayaphong, Rungroj
Boonyapiphat, Thanita
Aroonsiriwattana, Suchart
Ngamjanyaporn, Pornchai
Lip, Gregory Y. H.
author_sort Krittayaphong, Rungroj
collection PubMed
description OBJECTIVES: The aim of this study was to determine the causes of death among Asian non-valvular atrial fibrillation (AF) patients who were registered in a nationwide AF registry, and to investigate the differences in the causes of death in AF patients compared between those who were taking and not taking oral anticoagulant (OAC). METHODS: The COhort of antithrombotic use and Optimal INR Level in patients with non-valvular Atrial Fibrillation in Thailand (COOL-AF) study enrolled non-valvular AF patients from 27 centers in Thailand during 2014–2017 to create the COOL-AF Thailand registry. Cause of death was classified as cardiovascular (CV) death, non-CV death, or undetermined cause of death. All events were evaluated and verified by an independent adjudication committee. RESULTS: There was a total of 3,405 patients (mean age: 67.8 years, 41.8% female), and the mean follow-up duration was 31.8±8.7 months. Three hundred and eighty patients (11.2%) died during follow-up. CV death, non-CV death, and undetermined cause accounted for 121 (31.8%), 189 (49.7%), and 70 (18.4%) patients, respectively. Of those with a known cause of death, heart failure (10%), intracranial hemorrhage (ICH; 10%), sudden cardiac death (6.8%), and ischemic stroke (5.8%) were the most often observed causes of death. Concerning non-CV death, infection/sepsis (27.7%), cancer (5.5%), respiratory (5.2%), and major bleeding (4.5%) were the most prevalent causes of death. The use and type of OAC were found to be major determinants of ICH and major bleeding incidence. CONCLUSION: Death due to ischemic stroke was responsible for only 4.7% of all deaths in Asian AF patients. Non-CV death, such as infection/sepsis or malignancy, was more far more prevalent than CV death in Asian AF patients. An improved integrated care approach is needed to reduce the prevalence of non-CV death in Asian AF patients.
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spelling pubmed-99770192023-03-02 Causes of death of patients with non-valvular atrial fibrillation in Asians Krittayaphong, Rungroj Boonyapiphat, Thanita Aroonsiriwattana, Suchart Ngamjanyaporn, Pornchai Lip, Gregory Y. H. PLoS One Research Article OBJECTIVES: The aim of this study was to determine the causes of death among Asian non-valvular atrial fibrillation (AF) patients who were registered in a nationwide AF registry, and to investigate the differences in the causes of death in AF patients compared between those who were taking and not taking oral anticoagulant (OAC). METHODS: The COhort of antithrombotic use and Optimal INR Level in patients with non-valvular Atrial Fibrillation in Thailand (COOL-AF) study enrolled non-valvular AF patients from 27 centers in Thailand during 2014–2017 to create the COOL-AF Thailand registry. Cause of death was classified as cardiovascular (CV) death, non-CV death, or undetermined cause of death. All events were evaluated and verified by an independent adjudication committee. RESULTS: There was a total of 3,405 patients (mean age: 67.8 years, 41.8% female), and the mean follow-up duration was 31.8±8.7 months. Three hundred and eighty patients (11.2%) died during follow-up. CV death, non-CV death, and undetermined cause accounted for 121 (31.8%), 189 (49.7%), and 70 (18.4%) patients, respectively. Of those with a known cause of death, heart failure (10%), intracranial hemorrhage (ICH; 10%), sudden cardiac death (6.8%), and ischemic stroke (5.8%) were the most often observed causes of death. Concerning non-CV death, infection/sepsis (27.7%), cancer (5.5%), respiratory (5.2%), and major bleeding (4.5%) were the most prevalent causes of death. The use and type of OAC were found to be major determinants of ICH and major bleeding incidence. CONCLUSION: Death due to ischemic stroke was responsible for only 4.7% of all deaths in Asian AF patients. Non-CV death, such as infection/sepsis or malignancy, was more far more prevalent than CV death in Asian AF patients. An improved integrated care approach is needed to reduce the prevalence of non-CV death in Asian AF patients. Public Library of Science 2023-03-01 /pmc/articles/PMC9977019/ /pubmed/36857361 http://dx.doi.org/10.1371/journal.pone.0282455 Text en © 2023 Krittayaphong et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Krittayaphong, Rungroj
Boonyapiphat, Thanita
Aroonsiriwattana, Suchart
Ngamjanyaporn, Pornchai
Lip, Gregory Y. H.
Causes of death of patients with non-valvular atrial fibrillation in Asians
title Causes of death of patients with non-valvular atrial fibrillation in Asians
title_full Causes of death of patients with non-valvular atrial fibrillation in Asians
title_fullStr Causes of death of patients with non-valvular atrial fibrillation in Asians
title_full_unstemmed Causes of death of patients with non-valvular atrial fibrillation in Asians
title_short Causes of death of patients with non-valvular atrial fibrillation in Asians
title_sort causes of death of patients with non-valvular atrial fibrillation in asians
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977019/
https://www.ncbi.nlm.nih.gov/pubmed/36857361
http://dx.doi.org/10.1371/journal.pone.0282455
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