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Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry
Background Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF. Methods We prospectivel...
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| Published in: | European journal of clinical investigation 2021-04, Vol.51 (4), p.e13431-n/a |
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| creator | Bertomeu‐Gonzalez, Vicente Moreno‐Arribas, José Esteve‐Pastor, María Asunción Roldán‐Rabadán, Inmaculada Muñiz, Javier Otero García, Déborah Ruiz‐Ortiz, Martín Cequier, Ángel Bertomeu‐Martínez, Vicente Badimón, Lina Anguita, Manuel Lip, Gregory Y. H. Marín, Francisco |
| description | Background
Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF.
Methods
We prospectively included 1956 patients (mean age 73.8 ± 9.5 years, 44.0% women) receiving oral anticoagulant therapy for AF. Clinical characteristics were collected at baseline. Patients were followed for a period of 3 years. Survival analysis and multivariable regression analyses were performed to assess variables related to death, stroke, bleeding, myocardial infarction and major adverse cardiovascular events (MACE).
Results
Patients with PAD (n = 118; 6%) exhibited higher rates of cardiovascular risk factors and cardiovascular diseases. After 3 years of follow‐up, there were a total of 255 deaths (no PAD 233, vs PAD 22), 45 strokes (43 vs 2), 146 major bleedings (136 vs 10) and 168 MACE (148 vs 20). On univariate analysis, there was a higher risk of cardiovascular mortality (2.02%/year no PAD vs 4.08%/year PAD, P = .02), myocardial infarction (0.99%/year no PAD vs 2.43%/year PAD, P = .02) and MACE (3.18%/year no PAD vs 6.99%/year PAD, P |
| doi_str_mv | 10.1111/eci.13431 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2451853546</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2499865089</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3881-bd77c4e27a1deca7b0362bbd620cd16d941d5aee8456d72b763dcd10d60dddfb3</originalsourceid><addsrcrecordid>eNp10UtL7DAcBfBwuXIdHwu_gATuRhfVPJq0dTcMPgZEBXVd0uRfJ9I2NUmRuZ_-RkddCGaTxflxSDgIHVByQtM5BW1PKM85_YVmlEuRMS7ZbzQjhOYZqwq2jXZCeCaElJSzP2ibcyJFIcUM_bsDb8cVeNVh5SP4NTY2gAqA1WCw7uxgdcrcFLXrIWA74FFFC0MM-NXGFVbR2wRa23jbdSlywxmeYw-j8xG33vU4rgBfzG8e5vfL5VvyZEP06z201aouwP7HvYseL84fFlfZ9e3lcjG_zjQvS5o1pih0DqxQ1IBWRUPS55rGSEa0odJUOTVCAZS5kKZgTSG5SQExkhhj2obvoqNN7-jdywQh1r0NGtJbB3BTqFkuaCm4yGWif7_RZzf5Ib0uqaoqpSBlldTxRmnvQvDQ1qO3vfLrmpL6bZA6DVK_D5Ls4Ufj1PRgvuTnAgmcbsCr7WD9c1N9vlhuKv8DN1-Vng</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2499865089</pqid></control><display><type>article</type><title>Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry</title><source>Wiley</source><creator>Bertomeu‐Gonzalez, Vicente ; Moreno‐Arribas, José ; Esteve‐Pastor, María Asunción ; Roldán‐Rabadán, Inmaculada ; Muñiz, Javier ; Otero García, Déborah ; Ruiz‐Ortiz, Martín ; Cequier, Ángel ; Bertomeu‐Martínez, Vicente ; Badimón, Lina ; Anguita, Manuel ; Lip, Gregory Y. H. ; Marín, Francisco</creator><creatorcontrib>Bertomeu‐Gonzalez, Vicente ; Moreno‐Arribas, José ; Esteve‐Pastor, María Asunción ; Roldán‐Rabadán, Inmaculada ; Muñiz, Javier ; Otero García, Déborah ; Ruiz‐Ortiz, Martín ; Cequier, Ángel ; Bertomeu‐Martínez, Vicente ; Badimón, Lina ; Anguita, Manuel ; Lip, Gregory Y. H. ; Marín, Francisco ; FANTASIIA Study Investigators ; FANTASIIA Study Investigators</creatorcontrib><description>Background
Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF.
Methods
We prospectively included 1956 patients (mean age 73.8 ± 9.5 years, 44.0% women) receiving oral anticoagulant therapy for AF. Clinical characteristics were collected at baseline. Patients were followed for a period of 3 years. Survival analysis and multivariable regression analyses were performed to assess variables related to death, stroke, bleeding, myocardial infarction and major adverse cardiovascular events (MACE).
Results
Patients with PAD (n = 118; 6%) exhibited higher rates of cardiovascular risk factors and cardiovascular diseases. After 3 years of follow‐up, there were a total of 255 deaths (no PAD 233, vs PAD 22), 45 strokes (43 vs 2), 146 major bleedings (136 vs 10) and 168 MACE (148 vs 20). On univariate analysis, there was a higher risk of cardiovascular mortality (2.02%/year no PAD vs 4.08%/year PAD, P = .02), myocardial infarction (0.99%/year no PAD vs 2.43%/year PAD, P = .02) and MACE (3.18%/year no PAD vs 6.99%/year PAD, P < .01). There was no statistically significant association with these events after multivariable adjustment.
Conclusions
In a large cohort of anticoagulated patients with AF, the presence of PAD represents a higher risk subgroup and is associated with worse crude outcomes. The exact contribution of the PAD independently of other cardiovascular diseases or risk factors requires further investigation.</description><identifier>ISSN: 0014-2972</identifier><identifier>EISSN: 1365-2362</identifier><identifier>DOI: 10.1111/eci.13431</identifier><identifier>PMID: 33065765</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Anticoagulants ; atrial fibrillation ; Bleeding ; Cardiac arrhythmia ; Cardiovascular diseases ; Cerebral infarction ; Clinical outcomes ; Fibrillation ; Health risks ; Heart attacks ; Medical prognosis ; mortality ; Myocardial infarction ; peripheral artery disease ; prognosis ; Regression analysis ; Risk analysis ; Risk factors ; Risk groups ; Statistical analysis ; stroke ; Subgroups ; Survival analysis ; Vascular diseases</subject><ispartof>European journal of clinical investigation, 2021-04, Vol.51 (4), p.e13431-n/a</ispartof><rights>2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd</rights><rights>2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 Stichting European Society for Clinical Investigation Journal Foundation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3881-bd77c4e27a1deca7b0362bbd620cd16d941d5aee8456d72b763dcd10d60dddfb3</citedby><cites>FETCH-LOGICAL-c3881-bd77c4e27a1deca7b0362bbd620cd16d941d5aee8456d72b763dcd10d60dddfb3</cites><orcidid>0000-0001-5309-0562 ; 0000-0002-1479-7044 ; 0000-0003-3104-3460</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33065765$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bertomeu‐Gonzalez, Vicente</creatorcontrib><creatorcontrib>Moreno‐Arribas, José</creatorcontrib><creatorcontrib>Esteve‐Pastor, María Asunción</creatorcontrib><creatorcontrib>Roldán‐Rabadán, Inmaculada</creatorcontrib><creatorcontrib>Muñiz, Javier</creatorcontrib><creatorcontrib>Otero García, Déborah</creatorcontrib><creatorcontrib>Ruiz‐Ortiz, Martín</creatorcontrib><creatorcontrib>Cequier, Ángel</creatorcontrib><creatorcontrib>Bertomeu‐Martínez, Vicente</creatorcontrib><creatorcontrib>Badimón, Lina</creatorcontrib><creatorcontrib>Anguita, Manuel</creatorcontrib><creatorcontrib>Lip, Gregory Y. H.</creatorcontrib><creatorcontrib>Marín, Francisco</creatorcontrib><creatorcontrib>FANTASIIA Study Investigators</creatorcontrib><creatorcontrib>FANTASIIA Study Investigators</creatorcontrib><title>Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry</title><title>European journal of clinical investigation</title><addtitle>Eur J Clin Invest</addtitle><description>Background
Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF.
Methods
We prospectively included 1956 patients (mean age 73.8 ± 9.5 years, 44.0% women) receiving oral anticoagulant therapy for AF. Clinical characteristics were collected at baseline. Patients were followed for a period of 3 years. Survival analysis and multivariable regression analyses were performed to assess variables related to death, stroke, bleeding, myocardial infarction and major adverse cardiovascular events (MACE).
Results
Patients with PAD (n = 118; 6%) exhibited higher rates of cardiovascular risk factors and cardiovascular diseases. After 3 years of follow‐up, there were a total of 255 deaths (no PAD 233, vs PAD 22), 45 strokes (43 vs 2), 146 major bleedings (136 vs 10) and 168 MACE (148 vs 20). On univariate analysis, there was a higher risk of cardiovascular mortality (2.02%/year no PAD vs 4.08%/year PAD, P = .02), myocardial infarction (0.99%/year no PAD vs 2.43%/year PAD, P = .02) and MACE (3.18%/year no PAD vs 6.99%/year PAD, P < .01). There was no statistically significant association with these events after multivariable adjustment.
Conclusions
In a large cohort of anticoagulated patients with AF, the presence of PAD represents a higher risk subgroup and is associated with worse crude outcomes. The exact contribution of the PAD independently of other cardiovascular diseases or risk factors requires further investigation.</description><subject>Anticoagulants</subject><subject>atrial fibrillation</subject><subject>Bleeding</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular diseases</subject><subject>Cerebral infarction</subject><subject>Clinical outcomes</subject><subject>Fibrillation</subject><subject>Health risks</subject><subject>Heart attacks</subject><subject>Medical prognosis</subject><subject>mortality</subject><subject>Myocardial infarction</subject><subject>peripheral artery disease</subject><subject>prognosis</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Risk groups</subject><subject>Statistical analysis</subject><subject>stroke</subject><subject>Subgroups</subject><subject>Survival analysis</subject><subject>Vascular diseases</subject><issn>0014-2972</issn><issn>1365-2362</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10UtL7DAcBfBwuXIdHwu_gATuRhfVPJq0dTcMPgZEBXVd0uRfJ9I2NUmRuZ_-RkddCGaTxflxSDgIHVByQtM5BW1PKM85_YVmlEuRMS7ZbzQjhOYZqwq2jXZCeCaElJSzP2ibcyJFIcUM_bsDb8cVeNVh5SP4NTY2gAqA1WCw7uxgdcrcFLXrIWA74FFFC0MM-NXGFVbR2wRa23jbdSlywxmeYw-j8xG33vU4rgBfzG8e5vfL5VvyZEP06z201aouwP7HvYseL84fFlfZ9e3lcjG_zjQvS5o1pih0DqxQ1IBWRUPS55rGSEa0odJUOTVCAZS5kKZgTSG5SQExkhhj2obvoqNN7-jdywQh1r0NGtJbB3BTqFkuaCm4yGWif7_RZzf5Ib0uqaoqpSBlldTxRmnvQvDQ1qO3vfLrmpL6bZA6DVK_D5Ls4Ufj1PRgvuTnAgmcbsCr7WD9c1N9vlhuKv8DN1-Vng</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Bertomeu‐Gonzalez, Vicente</creator><creator>Moreno‐Arribas, José</creator><creator>Esteve‐Pastor, María Asunción</creator><creator>Roldán‐Rabadán, Inmaculada</creator><creator>Muñiz, Javier</creator><creator>Otero García, Déborah</creator><creator>Ruiz‐Ortiz, Martín</creator><creator>Cequier, Ángel</creator><creator>Bertomeu‐Martínez, Vicente</creator><creator>Badimón, Lina</creator><creator>Anguita, Manuel</creator><creator>Lip, Gregory Y. H.</creator><creator>Marín, Francisco</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5309-0562</orcidid><orcidid>https://orcid.org/0000-0002-1479-7044</orcidid><orcidid>https://orcid.org/0000-0003-3104-3460</orcidid></search><sort><creationdate>202104</creationdate><title>Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry</title><author>Bertomeu‐Gonzalez, Vicente ; Moreno‐Arribas, José ; Esteve‐Pastor, María Asunción ; Roldán‐Rabadán, Inmaculada ; Muñiz, Javier ; Otero García, Déborah ; Ruiz‐Ortiz, Martín ; Cequier, Ángel ; Bertomeu‐Martínez, Vicente ; Badimón, Lina ; Anguita, Manuel ; Lip, Gregory Y. H. ; Marín, Francisco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3881-bd77c4e27a1deca7b0362bbd620cd16d941d5aee8456d72b763dcd10d60dddfb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anticoagulants</topic><topic>atrial fibrillation</topic><topic>Bleeding</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular diseases</topic><topic>Cerebral infarction</topic><topic>Clinical outcomes</topic><topic>Fibrillation</topic><topic>Health risks</topic><topic>Heart attacks</topic><topic>Medical prognosis</topic><topic>mortality</topic><topic>Myocardial infarction</topic><topic>peripheral artery disease</topic><topic>prognosis</topic><topic>Regression analysis</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>Statistical analysis</topic><topic>stroke</topic><topic>Subgroups</topic><topic>Survival analysis</topic><topic>Vascular diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bertomeu‐Gonzalez, Vicente</creatorcontrib><creatorcontrib>Moreno‐Arribas, José</creatorcontrib><creatorcontrib>Esteve‐Pastor, María Asunción</creatorcontrib><creatorcontrib>Roldán‐Rabadán, Inmaculada</creatorcontrib><creatorcontrib>Muñiz, Javier</creatorcontrib><creatorcontrib>Otero García, Déborah</creatorcontrib><creatorcontrib>Ruiz‐Ortiz, Martín</creatorcontrib><creatorcontrib>Cequier, Ángel</creatorcontrib><creatorcontrib>Bertomeu‐Martínez, Vicente</creatorcontrib><creatorcontrib>Badimón, Lina</creatorcontrib><creatorcontrib>Anguita, Manuel</creatorcontrib><creatorcontrib>Lip, Gregory Y. H.</creatorcontrib><creatorcontrib>Marín, Francisco</creatorcontrib><creatorcontrib>FANTASIIA Study Investigators</creatorcontrib><creatorcontrib>FANTASIIA Study Investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical investigation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bertomeu‐Gonzalez, Vicente</au><au>Moreno‐Arribas, José</au><au>Esteve‐Pastor, María Asunción</au><au>Roldán‐Rabadán, Inmaculada</au><au>Muñiz, Javier</au><au>Otero García, Déborah</au><au>Ruiz‐Ortiz, Martín</au><au>Cequier, Ángel</au><au>Bertomeu‐Martínez, Vicente</au><au>Badimón, Lina</au><au>Anguita, Manuel</au><au>Lip, Gregory Y. H.</au><au>Marín, Francisco</au><aucorp>FANTASIIA Study Investigators</aucorp><aucorp>FANTASIIA Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry</atitle><jtitle>European journal of clinical investigation</jtitle><addtitle>Eur J Clin Invest</addtitle><date>2021-04</date><risdate>2021</risdate><volume>51</volume><issue>4</issue><spage>e13431</spage><epage>n/a</epage><pages>e13431-n/a</pages><issn>0014-2972</issn><eissn>1365-2362</eissn><abstract>Background
Atrial fibrillation (AF) and peripheral artery disease (PAD) are common conditions that increase cardiovascular risk. We determined the association between PAD and prognosis in a cohort of real‐world patients receiving oral anticoagulant therapy for nonvalvular AF.
Methods
We prospectively included 1956 patients (mean age 73.8 ± 9.5 years, 44.0% women) receiving oral anticoagulant therapy for AF. Clinical characteristics were collected at baseline. Patients were followed for a period of 3 years. Survival analysis and multivariable regression analyses were performed to assess variables related to death, stroke, bleeding, myocardial infarction and major adverse cardiovascular events (MACE).
Results
Patients with PAD (n = 118; 6%) exhibited higher rates of cardiovascular risk factors and cardiovascular diseases. After 3 years of follow‐up, there were a total of 255 deaths (no PAD 233, vs PAD 22), 45 strokes (43 vs 2), 146 major bleedings (136 vs 10) and 168 MACE (148 vs 20). On univariate analysis, there was a higher risk of cardiovascular mortality (2.02%/year no PAD vs 4.08%/year PAD, P = .02), myocardial infarction (0.99%/year no PAD vs 2.43%/year PAD, P = .02) and MACE (3.18%/year no PAD vs 6.99%/year PAD, P < .01). There was no statistically significant association with these events after multivariable adjustment.
Conclusions
In a large cohort of anticoagulated patients with AF, the presence of PAD represents a higher risk subgroup and is associated with worse crude outcomes. The exact contribution of the PAD independently of other cardiovascular diseases or risk factors requires further investigation.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>33065765</pmid><doi>10.1111/eci.13431</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5309-0562</orcidid><orcidid>https://orcid.org/0000-0002-1479-7044</orcidid><orcidid>https://orcid.org/0000-0003-3104-3460</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | Wiley |
| subjects | Anticoagulants atrial fibrillation Bleeding Cardiac arrhythmia Cardiovascular diseases Cerebral infarction Clinical outcomes Fibrillation Health risks Heart attacks Medical prognosis mortality Myocardial infarction peripheral artery disease prognosis Regression analysis Risk analysis Risk factors Risk groups Statistical analysis stroke Subgroups Survival analysis Vascular diseases |
| title | Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A report from the FANTASIIA registry |
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