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Proietti M, Esteve-Pastor MA, Rivera-Caravaca JM, Roldán V, Roldán Rabadán I, Muñiz J, Cequier Á, Bertomeu-Martínez V, Badimón L, Anguita M, Lip GYH, Marín F. Relationship between multimorbidity and outcomes in atrial fibrillation. Exp Gerontol 2021; 153:111482. [PMID: 34303775 DOI: 10.1016/j.exger.2021.111482] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Multimorbidity is common in atrial fibrillation (AF) patients. Charlson comorbidity index (CCI) is used to evaluate multimorbidity in the general population. Limited long-term data are available on the relationship between CCI and AF. We examined the association between CCI, anticoagulation control and outcomes in AF patients. METHODS We studied 1956 from the FANTASIIA registry, an observational Spanish nationwide study on anticoagulated AF patients. Time in therapeutic range (TTR) was used to evaluate anticoagulation control. Stroke/TIA, major bleeding, cardiovascular (CV) death and all-cause death were study outcomes. RESULTS Mean ± SD CCI was 1.1 ± 1.2. Based on CCI quartiles, patients were categorised in four groups: 676 (34.6%) in Q1 (CCI 0); 683 (34.9%) in Q2 (CCI 1); 345 (17.6%) in Q3 (CCI 2); and 252 (12.9%) in Q4 (CCI ≥3). In vitamin K antagonist treated patients, the highest CCI quartile was inversely associated with TTR >70% (odds ratio:0.67, 95% confidence interval (CI):0.45-0.99). During observation, a progressively higher rate of major bleeding, CV death and all-cause death was found across the quartiles (all p < 0.001). The final Cox multivariable regression analysis showed an association with increasing risk for major bleeding occurrence in Q3 and Q4 (hazard ratio (HR):1.69, 95%CI:1.00-2.87 and HR:1.92, 95%CI:1.08-3.41). An increasing risk for all-cause death and CV death was found across CCI quartiles. CONCLUSIONS In a nationwide contemporary cohort of AF anticoagulated patients, multimorbidity was inversely associated with good anticoagulation control. A progressively higher risk for major bleeding, CV death and all-cause death was found across CCI quartiles.
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Affiliation(s)
- Marco Proietti
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
| | - María Asunción Esteve-Pastor
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Vanessa Roldán
- Department of Hematology and Clinical Oncology, Hospital Universitario Morales Meseguer, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | | | - Javier Muñiz
- Universidade da Coruña, Grupo de Investigación Cardiovascular, Departamento de Ciencias de la Salud e Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, Spain
| | - Ángel Cequier
- University Hospital of Bellvitge, Department of Cardiology, Barcelona, CIBERCV, Spain
| | | | - Lina Badimón
- Cardiovascular Research Center (CSIC-ICCC), Barcelona, Spain
| | - Manuel Anguita
- University Hospital Reina Sofia, Department of Cardiology, Cordoba, Spain
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
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Roldán Rabadán I, Esteve-Pastor MA, Anguita Sánchez M, Muñiz J, Ruiz Ortiz M, Marín F, Roldán V, Quesada MA, Camacho Siles J, Cequier Fillat A, Bertomeu Martinez V, Martínez Sellés M, Badimón L. Influence of sex on long-term prognosis in patients with atrial fibrillation treated with oral anticoagulants. Results from the prospective, nationwide FANTASIIA study. Eur J Intern Med 2020; 78:63-68. [PMID: 32303456 DOI: 10.1016/j.ejim.2020.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND While many risk factors for Atrial Fibrillation (AF) have been identified, there are important differences in their relative impact between sexes. The aim of our study was to investigate the influence of sex as a long-term predictor of adverse events in "real world" AF patients treated with direct oral anticoagulants. METHODS The FANTASIIA registry is a prospective, national and multicentric study including outpatients with anticoagulated AF patients. Baseline characteristics and adverse events at 3 years of follow-up were collected and classified by sex. Cox multivariate analysis was performed to investigate the role of sex in major events and composite outcomes. RESULTS A total of 1956 patients were included in the study. 43.9% of them were women, with a mean age of 73.8 ± 9.4 years (women were older 76.5 ± 7.9 vs 71.7 ± 10.1, p<0.001). Women had higher rate of cardiovascular risk factors and higher mean of CHA2DS2-VASc (4.4 ± 1.4 vs 3.7 ± 1.6, p<0.001) and HAS-BLED (2.1 ± 1.0 vs 1.9 ± 1.1, p<0.001) than men. After 3 years of follow-up, rates of major events were similar in both groups with limit difference for all-cause mortality (4.4%/year in women vs 5.6%/year in men; p = 0.056). However, all the composite events were more frequent in women. We observed in the non-adjusted adverse events lower rate of all-cause mortality (HR 0.62, 95%CI 0.47-0.81; p<0.001), composite 1 outcomes (HR 0.80, 95%CI 0.65-0.98; p = 0.029) and composite 2 (HR 0.77, 95%CI 0.64-0.94; p = 0.010) in women compared with men. In multivariate Cox regression analysis observed that female sex was an independently protector factor for all-cause mortality and for the composite outcomes 1 and 2. CONCLUSIONS In this "real world" study of anticoagulated AF patients, women could have a protective role against development of adverse events, mainly on all-cause mortality and combined events.
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Affiliation(s)
- Inmaculada Roldán Rabadán
- Department of Cardiology, Hospital Universitario La Paz, Po. Castellana 261, 28046 Madrid, Spain; Instituto de Investigación de La Paz (IDIPAZ), CIBER-CV, Spain.
| | - María Asunción Esteve-Pastor
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, IMIB-Arrixaca, CIBER-CV, Murcia, Spain
| | | | - Javier Muñiz
- Universidade da Coruña, Instituto Universitario de Ciencias de la Salud, Instituto de Investigación Biomédica de A Coruña (INIBIC), La Coruña, Spain
| | - Martín Ruiz Ortiz
- Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, IMIB-Arrixaca, CIBER-CV, Murcia, Spain
| | | | | | - José Camacho Siles
- Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Manuel Martínez Sellés
- Department of Cardiology, Hospital Universitario Gregorio Marañón, CIBERCV, Complutense University, European University of Madrid, Madrid, Spain
| | - Lina Badimón
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
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Barón-Esquivias G, Roldán Rabadán I, García Quintana A, Cerezo Manchado JJ, Antorrena Miranda I, Gómez-Barrado JJ, Pérez Paredes M, Santas E, Pindado Rodríguez J, Muñoz-Robles JA, Oliver-Miñarro D, Santamaría A. Use of edoxaban in clinical practice: Comparison of data from the Spanish population in the ETNA-AF-Europe registry. Future Cardiol 2020; 16:469-480. [PMID: 32228182 DOI: 10.2217/fca-2020-0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim: To ascertain the clinical profile and management of edoxaban in clinical practice. Materials & methods: Prospective, noninterventional postauthorization study of nonselected patients with atrial fibrillation treated with edoxaban from 12 European countries. Patients' baseline characteristics are presented. Results: A total of 13,638 patients (73.6 ± 9.5 years; 76.6/23.4% edoxaban 60/30 mg; CHA2DS2-VASc 3.1; 838 [6.1%] from Spain) were included. In Spain, the percentage of very elderly and fragile patients was greater and the risk of thromboembolism (CHA2DS2-VASc ≥2, 98.0 vs 87.3%; p < 0.001) and bleeding (HAS-BLED, 3.2 vs 2.7; p < 0.001) was greater in patients treated with edoxaban 30 mg. The proportion of patients taking edoxaban 30 mg was similar than in ENGAGE AF-TIMI 48. Conclusion: In Spain, patients treated with edoxaban were older and fragile.
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Affiliation(s)
| | | | - Antonio García Quintana
- Cardiology Service, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | - Matías Pérez Paredes
- Cardiology Service, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Enrique Santas
- Cardiology Service, Hospital Clínico Universitario, Valencia, Spain
| | | | | | | | - Amparo Santamaría
- Hematology service, Hospital Universitario del Vinalopó, Torrevieja, Spain
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Roldán Rabadán I, Alonso de Leciñana M, Barba Martín R, Páramo Fernández JA. Security profile of direct anticoagulants. Preferred use in atrial fibrillation. Clin Investig Arterioscler 2019; 31:263-270. [PMID: 31213323 DOI: 10.1016/j.arteri.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/12/2019] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
A multidisciplinary panel of cardiologists, neurologists, internal medicine and specialists in hemostasis and thrombosis has elaborated this document showing recent scientific evidences supporting a better profile of direct oral anticoagulants (DOACs) versus vitaminK antagonists (VKA), as well as the indications of specific antidotes and hemostatic agents to reverse the anticoagulant effects of DOACs. The analysis reinforces the best profile of DOACs and its special benefit in patients with basal high hemorrhagic risk.
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Affiliation(s)
| | | | - Raquel Barba Martín
- Servicio de Medicina Interna, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España
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López-Fernández T, Martín-García A, Roldán Rabadán I, Mitroi C, Mazón Ramos P, Díez-Villanueva P, Escobar Cervantes C, Alonso Martín C, Alonso Salinas GL, Arenas M, Arrarte Esteban VI, Ayala de La Peña F, Castro Fernández A, García Pardo H, García-Sanz R, González Porras JR, López de Sá E, Lozano T, Marco Vera P, Martínez Marín V, Mesa Rubio D, Montero Á, Oristrell G, Pérez de Prado A, Velasco del Castillo S, Virizuela Echaburu JA, Zatarain-Nicolás E, Anguita Sánchez M, Tamargo Menéndez J, Marín F, López-Sendón JL, Zamorano JL. Abordaje de la fibrilación auricular en pacientes con cáncer activo. Documento de consenso de expertos y recomendaciones. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2019.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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López-Fernández T, Martín-García A, Roldán Rabadán I, Mitroi C, Mazón Ramos P, Díez-Villanueva P, Escobar Cervantes C, Alonso Martín C, Alonso Salinas GL, Arenas M, Arrarte Esteban VI, Ayala de La Peña F, Castro Fernández A, García Pardo H, García-Sanz R, González Porras JR, López de Sá E, Lozano T, Marco Vera P, Martínez Marín V, Mesa Rubio D, Montero Á, Oristrell G, Pérez de Prado A, Velasco Del Castillo S, Virizuela Echaburu JA, Zatarain-Nicolás E, Anguita Sánchez M, Tamargo Menéndez J. Atrial Fibrillation in Active Cancer Patients: Expert Position Paper and Recommendations. ACTA ACUST UNITED AC 2019; 72:749-759. [PMID: 31405794 DOI: 10.1016/j.rec.2019.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/28/2019] [Indexed: 12/13/2022]
Abstract
Improvements in survival among cancer patients have revealed the clinical impact of cardiotoxicity on both cardiovascular and hematological and oncological outcomes, especially when it leads to the interruption of highly effective antitumor therapies. Atrial fibrillation is a common complication in patients with active cancer and its treatment poses a major challenge. These patients have an increased thromboembolic and hemorrhagic risk but standard stroke prediction scores have not been validated in this population. The aim of this expert consensus-based document is to provide a multidisciplinary and practical approach to the prevention and treatment of atrial fibrillation in patients with active cancer. This is a position paper of the Spanish Cardio-Oncology working group and the Spanish Thrombosis working group, drafted in collaboration with experts from the Spanish Society of Cardiology, the Spanish Society of Medical Oncology, the Spanish Society of Radiation Oncology, and the Spanish Society of Hematology.
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Affiliation(s)
| | - Ana Martín-García
- Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, CIBERCV, Salamanca, Spain
| | | | - Cristina Mitroi
- Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Pilar Mazón Ramos
- Servicio de Cardiología, Hospital Clínico Santiago de Compostela, CIBERCV, Santiago de Compostela, A Coruña, Spain
| | | | | | | | | | - Meritxell Arenas
- Servicio de Oncología Radioterápica, Hospital Universitario San Juan de Reus, Universidad Rovira i Virgili, Reus, Tarragona, Spain
| | | | | | | | - Héctor García Pardo
- Servicio de Cardiología, Hospital Santos Reyes, Aranda de Duero, Burgos, Spain
| | - Ramón García-Sanz
- Departamento de Hematología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, Salamanca, Spain
| | - José Ramón González Porras
- Departamento de Hematología, Complejo Asistencial Universitario de Salamanca (CAUSA), IBSAL, Salamanca, Spain
| | - Esteban López de Sá
- Servicio de Cardiología, Hospital Universitario La Paz, IdiPAZ, CIBERCV, Madrid, Spain
| | - Teresa Lozano
- Servicio de Cardiología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain
| | - Pascual Marco Vera
- Servicio de Hematología, Hospital General Universitario de Alicante, ISABIAL-FISABIO, Alicante, Spain
| | | | - Dolores Mesa Rubio
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ángel Montero
- Servicio de Oncología Radioterápica, Centro Integral Oncológico Clara Campal (CIOCC), Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Gerard Oristrell
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, CIBERCV, Barcelona, Spain
| | | | | | | | - Eduardo Zatarain-Nicolás
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | | | - Juan Tamargo Menéndez
- Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, CIBERCV, Madrid, Spain
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Anguita Sánchez M, Bertomeu Martínez V, Ruiz Ortiz M, Cequier Fillat Á, Roldán Rabadán I, Muñiz García J, Badimón Maestro L, Esteve Pastor MA, Marín Ortuño F. Direct oral anticoagulants versus vitamin K antagonists in real-world patients with nonvalvular atrial fibrillation. The FANTASIIA study. ACTA ACUST UNITED AC 2019; 73:14-20. [PMID: 31160265 DOI: 10.1016/j.rec.2019.02.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/14/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES To compare the long-term results of direct oral anticoagulants (DOAC) vs vitamin K antagonists (VKA) in real-world-patients with nonvalvular atrial fibrillation (NVAF) in a nationwide, prospective study. METHODS The FANTASIIA registry prospectively included outpatients with AF anticoagulated with DOAC or VKA (per protocol, proportion of VKA and DOAC 4:1), consecutively recruited from June 2013 to October 2014 in Spain. The incidence of major events was analyzed and compared according to the anticoagulant treatment received. RESULTS A total of 2178 patients were included in the study (mean age 73.8±9.4 years), and 43.8% were women. Of these, 533 (24.5%) received DOAC and 1645 (75.5%) VKA. After a median follow up of 32.4 months, patients receiving DOAC vs those receiving VKA had lower rates of stroke-0.40 (95%CI, 0.17-0.97) vs 1.07 (95%CI,0.79-1.46) patients/y, P=.032-, severe bleedings-2.13 (95%CI, 1.45-3.13) vs 3.28 (95%CI, 2.75-3.93) patients/y; P = .044-, cardiovascular death-1.20 (95%CI, 0.72-1.99) vs 2.45 (95%CI, 2.00-3.00) patients/y; P = .009-, and all-cause death-3.77 (95%CI, 2.83-5.01) vs 5.54 (95%CI, 4.83-6.34) patients/y; P = .016-. In a modified Cox regression model by the Andersen-Gill method for multiple events, hazard ratios for patients receiving DOAC were: 0.42 (0.16-1.07) for stroke; 0.47 (0.20-1.16) for total embolisms; 0.76 (0.50-1.15) for severe bleedings; 0.67 (0.39-1.18) for cardiovascular death; 0.86 (0.62-1.19) for all-cause death, and 0.82 (0.64-1.05) for the combined event consisting of stroke, embolism, severe bleeding, and all-cause death. CONCLUSIONS Compared with VKA, DOAC is associated with a trend to a lower incidence of all major events, including death, in patients with NVAF in Spain.
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Affiliation(s)
| | | | - Martín Ruiz Ortiz
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ángel Cequier Fillat
- Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Lina Badimón Maestro
- Instituto de Investigación Cardiovascular (CSIC-ICCC)-Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María Asunción Esteve Pastor
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, EL Palmar, Murcia, Spain
| | - Francisco Marín Ortuño
- Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, EL Palmar, Murcia, Spain
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Roldán Rabadán I, Esteve-Pastor MA, Anguita-Sánchez M, Muñiz J, Camacho Siles J, Quesada MA, Ruiz Ortiz M, Marín F, Martínez Sellés M, Bertomeu V, Lip GYH, Cequier Fillat A, Badimón L. Relation of quality of anticoagulation control with different management systems among patients with atrial fibrillation: Data from FANTASIIA Registry. Eur J Clin Invest 2018; 48:e12910. [PMID: 29424018 DOI: 10.1111/eci.12910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 02/04/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Anticoagulation control in patients with atrial fibrillation (AF) has a multidisciplinary approach although is usually managed by general practitioners (GP) or haematologists. The aim of our study was to assess the quality of anticoagulation control with vitamin K antagonists (VKAs) in relation to the responsible specialist in a "real-world" AF population. METHODS We consecutively enrolled VKA anticoagulated patients included in the FANTASIIA Registry from 2013 to 2015. We analysed demographical, clinical characteristics and the quality of anticoagulation control according to the specialist responsible (ie GPs or haematologists). RESULTS Data on 1584 patients were included (42.5% females, mean age 74.0 ± 9.4 years): 977 (61.7%) patients were controlled by GPs and 607 (38.3%) by haematologists. Patients managed by GPs had higher previous heart disease (53.2% vs 43.3%, P < .001), heart failure (32.9% vs 26.5%, P < .008) and dilated cardiomyopathy (15.2% vs 8.7%, P < .001) with better renal function (69.3 ± 24.7 vs 63.1 ± 21.4 mL/min, P < .001) compared to patients managed by haematologists. There was no difference between groups in the type of AF, CHA2 DS2 -VASc or HAS-BLED scores, but patients with electrical cardioversion were more prevalent in GP group. The overall mean time in therapeutic range (TTR) assessed by Rosendaal method was 61.5 ± 24.9%; 52.6% of patients had TTR<65% and 60% of patients had TTR<70%. TTR was significantly lower in patients controlled by haematologists than by GPs (63 ± 24.4 vs 59.2 ± 25.6, P < .005). CONCLUSIONS About 60% of AF patients anticoagulated with VKAs had poor anticoagulation control (ie TTR<70%), and their management was only slightly better than when it is managed by general practitioners.
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Affiliation(s)
- Inmaculada Roldán Rabadán
- Department of Cardiology, Hospital Universitario La Paz, Instituto de Investigación de La Paz (IDIPAZ), CIBER-CV, Madrid, Spain
| | - María Asunción Esteve-Pastor
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBER-CV, Murcia, Spain
| | | | - Javier Muñiz
- Instituto Universitario de Ciencias de la Salud, Instituto de Investigación Biomedica de A Coruña (INIBIC), Universidade da Coruña, CIBER-CV, A Coruña, Spain
| | - José Camacho Siles
- Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
| | | | - Martín Ruiz Ortiz
- Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBER-CV, Murcia, Spain
| | - Manuel Martínez Sellés
- Department of Cardiology, Hospital Universitario Gregorio Marañón, Complutense University, European University of Madrid, CIBER-CV, Madrid, Spain
| | - Vicente Bertomeu
- Department of Cardiology, Hospital Universitario de San Juan, CIBER-CV, Alicante, Spain
| | - Gregory Y H Lip
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Lina Badimón
- Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, CIBER-CV, Barcelona, Spain
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Carnero Montoro L, Roldán Rabadán I, Marín Ortuño F, Bertomeu Martínez V, Muñiz García J, Anguita Sánchez M. Diferencias en las características y el tratamiento de los pacientes con fibrilación auricular seguidos por cardiólogos y por otros especialistas. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Carnero Montoro L, Roldán Rabadán I, Marín Ortuño F, Bertomeu Martínez V, Muñiz García J, Anguita Sánchez M. Differences in the Characteristics and Management of Patients With Atrial Fibrillation Followed-up by Cardiologists and Other Specialists. Rev Esp Cardiol (Engl Ed) 2017; 70:883-886. [PMID: 28256334 DOI: 10.1016/j.rec.2016.11.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/14/2016] [Indexed: 06/06/2023]
Affiliation(s)
| | | | - Francisco Marín Ortuño
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
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Roldán Rabadán I, Anguita Sánchez M, Marín F, Quesada MA, Camacho Siles J, Peinado R, Bertomeu V, Cequier Fillat Á, Badimón L, Muñiz J. Tratamiento antiarrítmico actual de la fibrilación auricular no valvular en España. Datos del Registro FANTASIIA. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Roldán Rabadán I, Anguita Sánchez M, Marín F, Quesada MA, Camacho Siles J, Peinado R, Bertomeu V, Cequier Fillat Á, Badimón L, Muñiz J. Current Antiarrhythmic Therapy for Nonvalvular Atrial Fibrillation in Spain. Data From the FANTASIIA Registry. ACTA ACUST UNITED AC 2015; 69:54-60. [PMID: 26093482 DOI: 10.1016/j.rec.2015.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/02/2015] [Indexed: 02/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES Recently, there have been many developments in the management of nonvalvular atrial fibrillation, antiarrhythmic and anticoagulant therapy, and nonpharmacological treatment, but these developments are not applied immediately in clinical practice. The aim of this study was to identify the overall management and antiarrhythmic therapy used in the current general population of patients with nonvalvular atrial fibrillation in Spain. METHODS A prospective, observational study of 1318 consecutive anticoagulated patients with nonvalvular atrial fibrillation, recruited between June 2013 and March 2014. We analyzed the patients' general characteristics, management, and antiarrhythmic therapy. RESULTS Mean age was 73.8 ± 9.4 years; 42.5% were women. Atrial fibrillation was paroxysmal in 28% of the patients, permanent in 50%, persistent in 17.6%, long-standing persistent in 4.5%, and new-onset in 66 patients (5%). A rhythm control strategy was chosen in 39.4% of the patients and rate control in 60.6%. Beta-blockers were prescribed in 60.2% of the patients, digoxin in 19.5%, and calcium channel antagonists in 10.7%. The antiarrhythmic agents used were amiodarone (12.6%), flecainide (8.9%), propafenone (0.4%), sotalol (0.5%), and dronedarone (2.3%). Cardioversion had been performed previously in 41.9% of the patients, ablation in 3.4%, and atrial appendage closure in 0.2%. CONCLUSIONS Currently, patients with nonvalvular atrial fibrillation in Spain are managed mainly with rate control, and beta-blockers in particular. They receive few antiarrhythmic agents and only a very small number of these patients undergo nonpharmacological treatments.
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Affiliation(s)
| | | | - Francisco Marín
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | | | - José Camacho Siles
- Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, Spain
| | - Rafael Peinado
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Vicente Bertomeu
- Servicio de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - Ángel Cequier Fillat
- Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lina Badimón
- Centro de Investigación Cardiovascular, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Javier Muñiz
- Instituto Universitario de Ciencias de la Salud, Universidad de A Coruña, A Coruña, Spain
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Navas Lobato MÁ, Martín Reyes R, Peinado Peinado R, Lurueña Lobo P, Roldán Rabadán I, López Sendón JL. Características clínicas, epidemiología y pronóstico del síndrome coronario agudo sin elevación del segmento ST con coronarias sanas. Med Clin (Barc) 2008; 131:653-5. [DOI: 10.1157/13128723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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