Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology

• Published in: ESC Heart Failure Vol. 7; no. 6; pp. 3601 - 3609
• Main Authors: Mizia‐Stec, Katarzyna, Caforio, Alida L.P., Charron, Philippe, Gimeno, Juan R., Elliott, Perry, Kaski, Juan Pablo, Maggioni, Aldo P., Tavazzi, Luigi, Rigopoulos, Angelos G., Laroche, Cecile, Frigy, Attila, Zachara, Elisabetta, Pena‐Pena, Maria Luisa, Olusegun‐Joseph, Akinsanya, Pinto, Yigal, Sala, Simone, Drago, Fabrizio, Blagova, Olga, Reznik, Elena, Tendera, Michał
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.12.2020; Wiley; John Wiley and Sons Inc
• Subjects: Age; Anticoagulation; Arrhythmogenic right ventricular cardiomyopathy; Atrial fibrillation; Body mass index; Cardiac arrhythmia; Cardiology; Cardiomyopathy; Dilated cardiomyopathy; Disease; Hypertrophic cardiomyopathy; Ischemia; Life Sciences; Myocarditis; Neuromuscular diseases; Original; Original s; Patients; Population; Restrictive cardiomyopathy; Stroke; Transient ischemic attack; Variables; New York; United States > US; Hypertrophic cardiomyopathy; Restrictive cardiomyopathy; Anticoagulation; Arrhythmogenic right ventricular cardiomyopathy; Dilated cardiomyopathy; Atrial fibrillation
• ISSN: 2055-5822; 2055-5822
• DOI: 10.1002/ehf2.12854

Aims Cardiomyopathies are a heterogeneous group of disorders that increase the risk for atrial fibrillation (AF). The aim of the study is to assess the prevalence of AF, anticoagulation management, and risk of stroke/transient ischaemic attack (TIA) in patients with cardiomyopathy. Methods and results Three thousand two hundred eight consecutive adult patients with cardiomyopathy (34.9% female; median age: 55.0 years) were prospectively enrolled as part of the EURObservational Research Programme Cardiomyopathy/Myocarditis Registry. At baseline, 903 (28.2%) patients had AF (29.4% dilated, 27.5% hypertrophic, 51.5% restrictive, and 14.7% arrhythmogenic right ventricular cardiomyopathy, P < 0.001). AF was associated with more advanced New York Heart Association class (P < 0.001), increased prevalence of cardiovascular risk factors and co‐morbidities, and a history of stroke/TIA (P < 0.001). Oral anticoagulation was administered in 71.7% of patients with AF (vitamin K antagonist: 51.6%; direct oral anticoagulant: 20.1%). At 1 year follow‐up, the incidence of cardiovascular endpoints was as follows: stroke/TIA 1.85% (AF vs. non‐AF: 3.17% vs. 1.19%, P < 0.001), death from any cause 3.43% (AF vs. non‐AF: 5.39% vs. 2.50%, P < 0.001), and death from heart failure 1.67% (AF vs. non‐AF: 2.44% vs. 1.31%, P = 0.033). The independent predictors for stroke/TIA were as follows: AF [odds ratio (OR) 2.812, P = 0.005], history of stroke (OR 7.311, P = 0.010), and anaemia (OR 3.119, P = 0.006). Conclusions The study reveals a high prevalence and diverse distribution of AF in patients with cardiomyopathies, inadequate anticoagulation regimen, and high risk of stroke/TIA in this population.