Characteristics and 2-year outcomes of dabigatran treatment in patients with heart failure and atrial fibrillation: GLORIA-AF.

Autor: Dubner SJ; Clínica y Maternidad Suizo Argentina, Buenos Aires, Argentina., Teutsch C; Boehringer Ingelheim International GmbH, Ingelheim, Germany., Huisman MV; Leiden University Medical Center, Leiden, the Netherlands., Diener HC; University Hospital Essen, Essen, Germany., Halperin J; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Rothman KJ; RTI Health Solutions, Research Triangle Institute, Research Triangle Park, NC, USA., Ma CS; Atrial Fibrillation Center, Beijing Anzhen Hospital, Beijing, People's Republic of China., Chuquiure-Valenzuela E; Heart Failure Center, National Institute of Cardiology, Tlalpan, Mexico., Bergler-Klein J; Department of Cardiology, University Clinic of Internal Medicine II, Medical University of Vienna, Vienna, Austria., Zint K; Boehringer Ingelheim International GmbH, Ingelheim, Germany., Riou França L; Boehringer Ingelheim International GmbH, Ingelheim, Germany., Lu S; Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA., Paquette M; Boehringer Ingelheim, Burlington, ON, Canada., Lip GYH; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.; Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2020 Oct; Vol. 7 (5), pp. 2679-2689. Date of Electronic Publication: 2020 Jul 02.
DOI: 10.1002/ehf2.12857
Abstrakt: Aims: This study aimed to describe baseline characteristics of patients with atrial fibrillation (AF) at risk of stroke with and without history of heart failure (HF) and report 2-year outcomes in the dabigatran-treated subset of a prospective, global, observational study (GLORIA-AF).
Methods and Results: Newly diagnosed patients with AF and CHA 2 DS 2 -VASc score ≥ 1 were consecutively enrolled. Baseline characteristics were assessed by the presence or absence of HF diagnosis at enrolment. Incidence rates for outcomes in dabigatran-treated patients were estimated with and without standardization by stroke (excluding HF component) and bleeding risk scores. A total of 15 308 eligible patients were enrolled, including 15 154 with known HF status; of these, 3679 (24.0%) had been diagnosed with HF, 11 475 (75.0%) had not. Among 4873 dabigatran-treated patients, 1169 (24.0%) had HF, and 3658 (75.1%) did not; the risk of stroke was high (CHA 2 DS 2 -VASc score ≥ 2) for 94.3% of patients with HF and 85.8% without, while 6.0% and 7.0%, respectively, had a high bleeding risk (HAS-BLED ≥ 3). Incidence rates of all-cause death in dabigatran-treated patients with and without HF, standardized for CHA 2 DS 2 -VASc and HAS-BLED scores, were 4.76 vs. 1.80 per 100 patient years (py), with roughly comparable rates of stroke (0.82 vs. 0.60 per 100 py) and major bleeding (1.20 vs. 0.92 per 100 py).
Conclusions: Patients with AF and history of HF may have greater disease burden at AF diagnosis and increased mortality rates vs. patients without HF. Stroke and major bleeding rates were roughly comparable between groups confirming the long-term safety and effectiveness of dabigatran in patients with HF.
(© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)
Databáze: MEDLINE
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