Patients with atrial fibrillation and mid-range ejection fraction differ in anticoagulation pattern, thrombotic and mortality risk independently of CHA 2 DS 2 -VAS C score

AbstractAtrial fibrillation (AF) patients with mid-range left ventricular ejection fraction (mrEF) of 40 –49% have neither preserved (pEF >  50%) nor reduced (rEF <  40%) EF and are increasingly being recognized as a distinct group with specific clinical risks. We aimed to retrospectively investigate clinical characteristics and associated thrombotic, bleeding and mortality risks of mrEF in comparison to pEF and rEF in a cohort of 1000 non-valvular AF patient s presenting in our institution during the period 2013–2018. Patients with mrEF presented with older age (P <  0.001) and a higher frequency of arterial hypertension (P = 0.001) in comparison to both pEF and rEF patients. In comparison to pEF, mrEF patients were more likely to have diabetes mellitus (P = 0.004), lower HDL-cholesterol (P <  0.001) and lower estimated glomerular filtration rate (P <  0.001), significantly higher CHA2DS2-VASC score (P <  0.001), significantly higher HAS-BLED score (P = 0.002) and had a higher likelihood of receiving anticoagulant therapy, mostly warfarin (P = 0.001). In addition, mrEF patients had a significantly higher risk of thrombotic events (HR = 2.22;P = 0.015), death (HR = 1.71;P = 0.005) and composite endpoint of thrombosis, bleeding or death (HR = 1.65;P = 0.003) in comparison to pEF patients, but did not significantly differ in comparison to rEF patients. There was no significant difference regar...
Source: Heart and Vessels - Category: Cardiology Source Type: research