"Comprehensive" approach to management necessary for AF -
By Eleanor McDermid
Death is more than stroke risk in patients with atrial fibrillation (FA), especially during the first 4 months after diagnosis, research shows.
the rate of all-cause mortality among patients in the cohort 17.162 GARFIELD-AF over 2 years was 3.83 per 100 person-years, while the rate race / systemic embolism was 1, 25 per 100 person-years, the report Jean-Pierre Bassand (University of Besançon, France) and the study co-authors.
congestive heart failure was the second most common event, a rate 2.41 per 100 person-years, while major bleeding and acute coronary syndromes occurred at respective rates of 0, 70 and 0.63 per 100 person-years.
The patients had a mean age of 69.8 years and 43.8% were women. Death was more often from cardiovascular causes, representing 40.5% of deaths, but congestive heart failure and other vascular causes were most common among them, representing 10.8% and 11, 1% of all deaths, respectively, whereas only 5.1% of deaths were caused by ischemic stroke.
"such a death rate from stroke down perhaps because> 60% of the population was anticoagulated" the researchers write in the European Heart Journal . Indeed, the use of anticoagulation was associated with a significant 35% reduction in mortality risk.
The relative scarcity of stroke mortality leads them to suggest that "a more holistic approach" may be necessary to manage AF patients, beyond anticoagulation.
"This could include interventions targeting other risk factors modifiable cause of death, "they said, noting that congestive heart failure, acute coronary syndrome, sudden death / unwitnessed, cancer, respiratory failure and infection / sepsis accounted for 65% of all deaths.
Cancer represents 10.3% of deaths, but the most common category was undetermined, to 23.7%.
team noted that rates of death, stroke / embolism and major bleeding were significantly higher during the first 4 months of follow that overall, 29%, 35% and 56%, respectively, with the greatest effect in patients with new-onset / newly diagnosed AF.
This suggests that new onset AF "can occur as a complication of cardiovascular disease or underlying chronic or acute cardiovascular not to infringe the early evolution," they say.
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