Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain.
Department of Cardiology, Hospital Universitario Ramon y Cajal, Madrid, Spain.
J Comp Eff Res. 2023 Mar;12(3):e220049. doi: 10.57264/cer-2022-0049. Epub 2023 Feb 7.
It is not well known how comorbidities may change the prognosis of atrial fibrillation (AF) patients. This study was aimed to analyze the impact of cardiovascular disease on this population. EMIR was a multicenter, prospective study, including 1433 AF patients taking rivaroxaban for ≥6 months. Data were analyzed according to the presence of vascular disease. Coronary artery disease was detected in 16.4%, peripheral artery disease/aortic plaque in 6.7%, vascular disease in 28.3%. Patients with coronary artery disease had higher rates (per 100 patient-years) of major adverse cardiovascular events (2.98 vs 0.71; p < 0.001) and cardiovascular death (1.79 vs 0.41; p = 0.004). Those with vascular disease had higher rates of thromboembolic events (1.47 vs 0.44; p = 0.007), major adverse cardiovascular events (2.03 vs 0.70; p = 0.004), and cardiovascular death (1.24 vs 0.39; p = 0.025). Patients with peripheral artery disease/aortic plaque had similar rates. AF patients with vascular disease have a higher risk of non-embolic outcomes.
目前尚不清楚合并症如何改变心房颤动 (AF) 患者的预后。本研究旨在分析心血管疾病对该人群的影响。EMIR 是一项多中心、前瞻性研究，共纳入 1433 例服用利伐沙班≥6 个月的 AF 患者。根据是否存在血管疾病对数据进行分析。冠心病的检出率为 16.4%，外周动脉疾病/主动脉斑块为 6.7%，血管疾病为 28.3%。冠心病患者的主要不良心血管事件（2.98 比 0.71；p<0.001）和心血管死亡（1.79 比 0.41；p=0.004）发生率更高（每 100 患者年）。有血管疾病的患者血栓栓塞事件（1.47 比 0.44；p=0.007）、主要不良心血管事件（2.03 比 0.70；p=0.004）和心血管死亡（1.24 比 0.39；p=0.025）发生率更高。患有外周动脉疾病/主动脉斑块的患者具有相似的发生率。患有血管疾病的 AF 患者发生非栓塞性结局的风险更高。
