ArticleBMJ open2018
Risk of cardiac and non-cardiac adverse events in community-dwelling older patients with atrial fibrillation: a prospective cohort study in the Netherlands.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Integrated management of atrial fibrillation in primary care: results of the ALL-IN cluster randomized trial.European heart journal · 2020Trial
- Hospital healthcare utilisation in patients with atrial fibrillation: the role of multimorbidity and age.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025Article
- Predicting adverse outcomes in adults with a community-acquired lower respiratory tract infection: a protocol for the development and validation of two prediction models for (i) all-cause hospitalisation and mortality and (ii) cardiovascular outcomes.Diagnostic and prognostic research · 2023Article
- Τhe association of heart failure across left ventricular ejection fraction with mortality in atrial fibrillation.ESC heart failure · 2021Article
- Incidence and predictors of hospitalization in patients with atrial fibrillation: results from the Chinese atrial fibrillation registry study.BMC cardiovascular disorders · 2021Article
- Impact of different anticoagulation management strategies on outcomes in atrial fibrillation: Dutch and Belgian results from the GARFIELD-AF registry.Journal of thrombosis and haemostasis : JTH · 2020Article
- Managing the Increasing Burden of Atrial Fibrillation through Integrated Care in Primary Care: A Cost-Effectiveness Analysis.International journal of integrated careArticle
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesPatients with atrial fibrillation (AF) are at increased risk of many adverse events, notably stroke. To prevent all adverse outcomes, integrated AF care is advocated though the potential domain for such multidisciplinary management is still unclear. Therefore, insight in the systemic nature of AF and identifying patients at risk of adverse events after oral anticoagulation is needed. The aim of this study is to first describe the risk of hospitalisation and mortality in community-dwelling older patients with AF using anticoagulants, and second to assess the association between traditional cardiac risk factors and these outcomes.
designA prospective cohort.
settingGeneral practice.
participants2068 patients with AF using oral anticoagulants. OUTCOME MEASURES: We calculated incidence rates (IRs) of ischaemic stroke, bleeding, hospitalisations and mortality, and compared risk factors using Cox regression between those with and without an adverse event, both for cardiac and non-cardiac causes.
resultsDuring a median follow-up of 2.7 (IQR 2.2-3.0) years, the IR per 100 person-years was 22.1 for hospitalisations and 6.7 for mortality. Non-cardiac events outnumbered cardiac events (IRs 15.7 vs 7.6 per 100 person-years for hospitalisation, p<0.001 and 5.0 vs 1.7, p<0.001 for mortality). As a comparison, the IRs for stroke and major bleeding were 1.7 and 0.8 per 100 person years, respectively. In multivariate models, high age, heart failure and vascular disease were independently associated with all-cause hospitalisation and- in addition to diabetes, previous stroke and renal disease-for all-cause mortality.
conclusionsIn anticoagulated community-dwelling patients with AF, stroke risk is effectively reduced and thus fairly low, whereas risks of hospitalisation and mortality remain high, importantly mainly for non-cardiac causes. Notably high age, heart failure and vascular disease are predictive for such outcomes and may be of value in identifying high-risk patients in the future. TRIAL REGISTRATION NUMBER: NTR3741.
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