Observational studyClinical cardiology2025
Evaluation of the Presence of Native Valvular Disease in Patients With Atrial Fibrillation Using the EHRA (Evaluated Heartvalves, Rheumatic, or Artificial) Classification.
Observational study in Clinical cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Clarifying the Scope of Native EHRA Type 2 Valvular Disease and Event Reporting in Anticoagulated Patients With Atrial Fibrillation.Clinical cardiology · 2026Article
- Critique on "Evaluation of the Presence of Native Valvular Disease in Patients With Atrial Fibrillation Using the EHRA (Evaluated Heartvalves, Rheumatic, or Artificial) Classification".Clinical cardiology · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundAtrial fibrillation (AF) in association with native valvular heart disease (VHD) is very common and both entities perpetuate each other due to volume and pressure overload. In 2017, the new EHRA classification (Evaluated Heartvalves, Rheumatic or Artificial) was proposed: EHRA 1 (mechanical prostheses or moderate/severe mitral stenosis), EHRA 2 (native valvular involvement or biological prosthesis) and EHRA 3 (without valve disease). The objective was to analyze the clinical characteristics as well as adverse events in the follow-up of AF patients under oral anticoagulation classified according EHRA classification.
methodsA multicenter retrospective observational descriptive study was designed and collected clinical, analytical, echocardiographic characteristics as well as adverse events in the follow-up of patients with AF who start oral anticoagulation.
results1.399 patients were included (mean age 75.3 ± 9.9 years; 659 (47.1%) male), of whom, 63% were classified as EHRA 2. After a median follow-up of 910 (IQR 730-1018) days, native EHRA 2 patients had higher event rates/patient-year as well as a higher total rate of adverse events such as cardiovascular mortality (5.5% vs. 1.1% event/patient-year; 8.7% vs. 1.1% p < 0.001) and major adverse cardiovascular events (MACE) (8.9% vs. 3.4% event/patient-year; 14.2% vs. 3.1% p < 0.001), compared with EHRA 3 patients. Multivariate logistic regression analysis showed that native EHRA 2 group was independently associated with all major adverse events.
conclusionIn anticoagulated AF patients, those with native valve involvement (EHRA 2) have a worse prognosis than patients without valve involvement (EHRA 3). The presence of native valvular disease is shown as an independent risk factor for all-cause mortality, major bleeding, cardiovascular mortality, ACS, heart failure, and MACE.
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