• Annals of medicine · Sep 2020

    Multicenter Study

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

    • Amaya García-Fernández, María Asunción Esteve-Pastor, Inmaculada Roldán-Rabadán, Javier Muñiz, Martín Ruiz Ortiz, Ángel Cequier, Vicente Bertomeu-Martínez, Lina Badimón, Déborah Otero, Manuel Anguita, Lip Gregory Y H GYH Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK. , Francisco Marín, and FANTASIIA investigators.
    • Department of Cardiology, Alicante General University Hospital, Sanitary and Biomedical Investigation Institute of Alicante (ISABIAL-FISABIO), Alicante, Spain.
    • Ann. Med. 2020 Sep 1; 52 (6): 300-309.

    BackgroundAtrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events.PurposeTo compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status.MethodsAF 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.Results1956 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].ConclusionAF 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.

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