Kocabaş Umut, Ergin Isil, Sönmez Sadi Can, Yavuz Veysel, Murat Selda, Özdemir Ibrahim Halil, Genç Ömer, Tüner Haşim, Meriç Bengisu Keskin, Aslan Onur, Dal Ahmet, Taşkın Uğur, Şen Taner, İbişoğlu Ersin, Erdoğan Aslan, Özgeyik Mehmet, Demir Mevlüt, Urgun Örsan Deniz, Doğduş Mustafa, Çakal Sinem, Çayırlı Sercan, Güler Arda, Karabulut Dilay, Dalgıç Onur, Murat Bektaş, Karabulut Umut, Öztekin Gülsüm Meral Yılmaz, Biter Halil İbrahim, Sinan Ümit Yaşar, Barış Veysel Özgür, Kaplan Mehmet, Altın Cihan, Kıvrak Tarık
Department of Cardiology, Başkent University Izmir Hospital, Izmir, Türkiye.
Department of Public Health, Faculty of Medicine, Ege University, Izmir, Türkiye.
Clin Cardiol. 2025 Jan;48(1):e70088. doi: 10.1002/clc.70088.
The main objective of this study is to determine the incidence and predictors of clinical outcomes in patients with AF treated with factor Xa inhibitors in a real-world setting.
The present study was a multicentre and observational study that included patients with AF who were treated with factor Xa inhibitors. The primary outcome was the composite of ischemic stroke, TIA, systemic embolism, major bleeding, and all-cause mortality.
A total of 1162 patients from 26 cardiology centers were included in this study, with a median age of 72 years. During the median 12-month follow-up period, the primary outcome occurred in 195 patients (16.8%). Treatment with rivaroxaban compared with apixaban and edoxaban showed a lower rate of ischemic stroke, TIA, and/or systemic embolism (2.2% vs. 4.7% vs. 6.5%, respectively, p = 0.014). The major bleeding rate was similar between all three factor Xa inhibitors. The all-cause mortality rate in the rivaroxaban group was lower compared with the apixaban and edoxaban groups (9.8% vs. 15.1% vs. 12.4%, respectively, p = 0.042). Overall, the frequency of primary outcome was 13.8%, 19.6%, and 20.6% for patients treated with rivaroxaban, apixaban, and edoxaban, respectively (p = 0.019). Older age, male sex, low body weight, high bleeding risk, heart failure, hypertension, liver failure, and treatment with apixaban 2.5 mg b.i.d. were independently associated with the development of primary outcome.
The follow-up data from the ANATOLIA-AF study provides detailed data about the incidence and independent predictors of adverse clinical outcomes in patients with AF treated with factor Xa inhibitor treatment.
本研究的主要目的是确定在真实世界中接受Xa因子抑制剂治疗的房颤患者临床结局的发生率及预测因素。
本研究为多中心观察性研究，纳入接受Xa因子抑制剂治疗的房颤患者。主要结局为缺血性卒中、短暂性脑缺血发作（TIA）、全身性栓塞、大出血及全因死亡率的复合终点。
本研究共纳入来自26个心脏病中心的1162例患者，中位年龄72岁。在中位12个月的随访期内，195例患者（16.8%）发生主要结局。与阿哌沙班和依度沙班相比，利伐沙班治疗的缺血性卒中、TIA和/或全身性栓塞发生率较低（分别为2.2%、4.7%和6.5%，p = 0.014）。三种Xa因子抑制剂的大出血发生率相似。利伐沙班组的全因死亡率低于阿哌沙班和依度沙班组（分别为9.8%、15.1%和12.4%，p = 0.042）。总体而言，接受利伐沙班、阿哌沙班和依度沙班治疗的患者主要结局发生率分别为13.8%、19.6%和20.6%（p = 0.019）。年龄较大、男性、低体重、高出血风险、心力衰竭、高血压、肝功能衰竭以及接受2.5 mg bid阿哌沙班治疗与主要结局的发生独立相关。
ANATOLIA-AF研究的随访数据提供了接受Xa因子抑制剂治疗的房颤患者不良临床结局发生率及独立预测因素的详细数据。
