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M Ruiz Ortiz, M A Esteve-Pastor, P Rana Miguez, J Muniz, F Marin, M Martinez-Selles, I Roldan, A Cequier, V Bertomeu, M Anguita, FANTASIIA Study Investigators, P6290
Independent predictors of major events in octogenarians patients with atrial fibrillation treated with anticoagulants: data from the FANTASIIA registry, a “real world”, nationwide, prospective study, European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy566.P6290, https://doi.org/10.1093/eurheartj/ehy566.P6290Close - Share Icon Share
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Background and aims: Our objective was to investigate prognostic factors in patients aged ≥80 years with atrial fibrillation (AF) treated with anticoagulants, included in an observational “real world” registry Method: The FANTASIIA registry prospectively included outpatients with AF and anticoagulant treatment (per protocol, proportion of vitamin K antagonists to direct oral anticoagulants was 4:1), consecutively recruited from 1.6.2013 to 15.10.2014 in 50 Spanish centers. Embolic events (stroke and systemic embolism), severe bleedings and cardiovascular and all-cause mortality rates after up to three years of follow-up were investigated in patients aged ≥80 years included in the study, and independent predictors of events were searched for by means of multivariate analysis.
Results: A total of 578 patients were included in the study (mean age 84.0±3.4 years, 44.3% male). After up to three years of follow up, a total of 1338 patients-year of observation accumulated. Rates of embolic events, severe bleedings and cardiovascular and all cause death (per 100 patients-year) were: 1.13 (95% CI 0.68–1.87), 4.19 (95% CI 3.22–5.46), 4.41 (95% CI 3.42–5.69) and 10.39 (95% CI 8.79–12.26), respectively. Only age (HR 1.17, 95% CI 1.03–1.32, p=0.02) and coronary disease (HR 3.09, 95% CI 1.09–8.76, p=0.03) independently predicted embolic events; renal failure (HR 2.40, 95% CI 1.40–4.11, p=0.001), previous severe bleeding (HR 5.11, 95% CI 2.28–11.46, p<0.001), and EHRA functional class II (HR 2.91, 95% CI 1.30–6.52, p=0.009), severe bleedings; age (HR 1.10, 95% CI 1.03–1.18, p=0.007), renal failure (HR 2.32, 95% CI 1.37–3.94, p=0.002), liver dysfunction (HR 4.36, 95% CI 1.03–18.45, p=0.046) and EHRA functional class III (HR 4.78, 95% CI 1.82–12.58, p=0.002), cardiovascular death; and age (HR 1.09, 95% CI 1.04–1.14, p<0.001), female sex (HR 0.67, 95% CI 0.47–0.95, p=0.03), diabetes (HR 1.59, 95% CI 1.10–2.30, p=0.01), chronic obstructive pulmonary disease (HR 1.54, 95% CI 1.03–2.31, p=0.04); renal failure (HR 1.69, 95% CI 1.18–2.40, p=0.004), and EHRA functional class (HR 2.19, 95% CI 1.31–3.67, p=0.003 for class II, HR 3.91, 95% CI 2.12–7.19, p<0.001 for class III and HR 18.86, 95% CI 4.13–86.18, p<0.001 for class IV), all-cause death.
