Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes: real-world data from the FANTASIIA Registry

Background:Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose:To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods:AF patients from FANTASIIA registry were included. Baselin...

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Detalles Bibliográficos
Autores: García-Fernández A, Esteve-Pastor MA, Rabadán IR, Muñiz J, Ruiz Ortiz M, Cequier Á, Bertomeu-Martínez V, Badimón L, Otero D, Anguita M, Lip GYH, Marín F
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p7481
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/7481
Access Level:acceso abierto
Palabra clave:Atrial fibrillation
oral anticoagulation
diabetes mellitus
risk factors
Descripción
Sumario:Background:Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose:To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods:AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated. Results:1956 patients (mean age 73.8 +/- 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%;p < .001) or renal disease (21.4% vs 15.9%;p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year;p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year;p < .001) and MACE (12.9%/year vs 6.8%/year;p < .001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 +/- 24.37% vs 62.68 +/- 25.31%;p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80);p = .024]. Conclusion:AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk.