Hypertrophic Cardiomyopathy Predicts Thromboembolism and Heart Failure in Patients With Nonvalvular Atrial Fibrillation　- A Prospective Analysis From the Hokuriku-Plus AF Registry.

Autor: Tsuda T; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Hayashi K; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Kato T; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Kusayama T; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Nakagawa Y; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Nomura A; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Tada H; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Usui S; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Sakata K; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Kawashiri MA; Kaga Medical Center., Fujino N; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences., Yamagishi M; Osaka University of Human Sciences., Takamura M; Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences.
Jazyk: angličtina
Zdroj: Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2023 Nov 24; Vol. 87 (12), pp. 1790-1797. Date of Electronic Publication: 2023 Oct 20.
DOI: 10.1253/circj.CJ-23-0418
Abstrakt: Background: The prognostic effect of concomitant hypertrophic cardiomyopathy (HCM) on adverse events in patients with atrial fibrillation (AF) has not been evaluated in a multicenter prospective cohort study in Japan.
Methods and results: Using the Hokuriku-Plus AF Registry, 1,396 patients with nonvalvular AF (1,018 men, 72.3±9.7 years old) were assessed prospectively; 72 (5.2%) had concomitant HCM. During a median follow-up of 5.0 years (interquartile range 3.5-5.3 years), 79 cases of thromboembolism (1.3 per 100 person-years) and 192 of heart failure (HF) (3.2 per 100 person-years) occurred. Kaplan-Meier analysis revealed that the HCM group had a significantly greater incidence of thromboembolism (P=0.002 by log-rank test) and HF (P<0.0001 by a log-rank test) than the non-HCM group. The Cox proportional hazards model demonstrated that persistent AF (adjusted hazard ratio 2.98, 95% confidence interval 1.56-6.21), the CHA 2 DS 2 -VASc score (1.35, 1.18-1.54), and concomitant HCM (2.48, 1.16-4.79) were significantly associated with thromboembolism. Conversely, concomitant HCM (2.81, 1.72-4.43), older age (1.07, 1.05-1.10), lower body mass index (0.95, 0.91-0.99), a history of HF (2.49, 1.77-3.52), and lower left ventricular ejection fraction (0.98, 0.97-0.99) were significantly associated with the development of HF.
Conclusions: Concomitant HCM predicts the incidence of thromboembolism and HF in AF patients.
Databáze: MEDLINE
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