Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients with Atrial Fibrillation: A Report from the GARFIELD-AF Registry

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dc.authorscopusid55702407700
dc.authorscopusid7005582756
dc.authorscopusid57205669191
dc.authorscopusid35411918900
dc.authorscopusid57204743826
dc.authorscopusid7006675579
dc.authorscopusid35377460800
dc.contributor.authorCorbalan R.
dc.contributor.authorBassand J.-P.
dc.contributor.authorIllingworth L.
dc.contributor.authorAmbrosio G.
dc.contributor.authorCamm A.J.
dc.contributor.authorFitzmaurice D.A.
dc.contributor.authorFox K.A.A.
dc.date.accessioned2024-08-04T20:03:40Z
dc.date.available2024-08-04T20:03:40Z
dc.date.issued2019
dc.departmentİnönü Üniversitesien_US
dc.description.abstractImportance: Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes. Objective: To assess the treatment strategies and 1-year clinical outcomes of antithrombotic and CHF therapies for patients with newly diagnosed AF with concomitant CHF stratified by etiology (ischemic cardiomyopathy [ICM] vs nonischemic cardiomyopathy [NICM]). Design, Setting, and Participants: The GARFIELD-AF registry is a prospective, noninterventional registry. A total of 52014 patients with AF were enrolled between March 2010 and August 2016. A total of 11738 patients 18 years and older with newly diagnosed AF (?6 weeks' duration) and at least 1 investigator-determined stroke risk factor were included. Data were analyzed from December 2017 to September 2018. Exposures: One-year follow-up rates of death, stroke/systemic embolism, and major bleeding were assessed. Main Outcomes and Measures: Event rates per 100 person-years were estimated from the Poisson model and Cox hazard ratios (HRs) and 95% confidence intervals. Results: The median age of the population was 71.0 years, 22987 of 52013 were women (44.2%) and 31958 of 52014 were white (61.4%). Of 11738 patients with CHF, 4717 (40.2%) had ICM and 7021 (59.8%) had NICM. Prescription of oral anticoagulant and antiplatelet drugs was not balanced between groups. Oral anticoagulants with or without antiplatelet drugs were used in 2753 patients with ICM (60.1%) and 5082 patients with NICM (73.7%). Antiplatelets were prescribed alone in 1576 patients with ICM (34.4%) and 1071 patients with NICM (15.5%). Compared with patients with NICM, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (72.6% [3439] vs 60.3% [4236]) and of ? blockers (63.3% [2988] vs 53.2% [3737]) was higher in patients with ICM. Rates of all-cause and cardiovascular death per 100 patient-years were significantly higher in the ICM group (all-cause death: ICM, 10.2; 95% CI, 9.2-11.1; NICM, 7.0; 95% CI, 6.4-7.6; cardiovascular death: ICM, 5.1; 95% CI, 4.5-5.9; NICM, 2.9; 95% CI, 2.5-3.4). Stroke/systemic embolism rates tended to be higher in ICM groups compared with NICM groups (ICM, 2.0; 95% CI, 1.6-2.5; NICM, 1.5; 95% CI, 1.3-1.9). Major bleeding rates were significantly higher in the ICM group (1.1; 95% CI, 0.8-1.4) compared with the NICM group (0.7; 95% CI, 0.5-0.9). Conclusions and Relevance: Patients with ICM received oral anticoagulants with or without antiplatelet drugs less frequently and antiplatelets alone more frequently than patients with NICM, but they received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers more often than patients with NICM. All-cause and cardiovascular death rates were higher in patients with ICM than patients with NICM. Trial Registration: ClinicalTrials.gov Identifier: NCT01090362. © 2019 American Medical Association. All rights reserved.en_US
dc.description.sponsorshipNational Heart, Lung, and Blood Institute, NHLBI; Bristol-Myers Squibb, BMS; Pfizer; AstraZeneca; Bayer; Sanofi; Boehringer Ingelheim; Janssen Pharmaceuticals; Portola Pharmaceuticals; Daiichi-Sankyo; Ono Pharmaceuticalen_US
dc.description.sponsorshipBoehringer Ingelheim as well as personal fees from Daiichi Sankyo and Pfizer/Bristol-Myers Squibb. Dr Fox has received grants and personal fees from Bayer/Janssen Pharmaceutica, grants from AstraZeneca, and personal fees from Sanofi/ Regeneron and Verseon. Dr Goldhaber has received research support from BiO2 Medical, Boehringer Ingelheim, Bristol-Myers Squibb, BTG EKOS Corporation, Daiichi Sankyo, Janssen Pharmaceutica, the National Heart, Lung, and Blood Institute, and the Thrombosis Research Institute and has consulted for Agile Medical, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Janssen Pharmaceutica, Portola Pharmaceuticals, and Soleno Therapeutics. Dr Goto has received grants from Bristol-Myers Squibb, the Japanese Ministry of Education, Culture, Sports, Science and Technology/Japan Society for the Promotion of Science, Ono Pharmaceutical, Sanofi, and Pfizer. Dr Haas has received personal fees from Aspen Medical Products, Bayer, Bristol-Myers Squibb, Daiichi Sankyo, Portola Pharmaceuticals, and Sanofi. Dr Kayani has received grants from Bayer. Dr Mantovani has received grants and personal fees from Bayer and Boehringer Ingelheim, grants from Daiichi Sankyo, and personal fees from Pfizer. Dr Misselwitz is employed by and owns stock in Bayer. Dr Turpie has received personal fees from Bayer and the Thrombosis Research Institute. Dr Kakkar has received grants and personal fees from Bayer as well as personal fees from Boehringer Ingelheim, Daiichi Sankyo, Janssen Pharmaceutica, Sanofi, and Verseon. No other disclosures were reported.en_US
dc.identifier.doi10.1001/jamacardio.2018.4729
dc.identifier.endpage548en_US
dc.identifier.issn2380-6583
dc.identifier.issue6en_US
dc.identifier.pmid31066873en_US
dc.identifier.scopus2-s2.0-85065588947en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage526en_US
dc.identifier.urihttps://doi.org/10.1001/jamacardio.2018.4729
dc.identifier.urihttps://hdl.handle.net/11616/92013
dc.identifier.volume4en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.ispartofJAMA Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectangiotensin receptor antagonisten_US
dc.subjectanticoagulant agenten_US
dc.subjectantithrombocytic agenten_US
dc.subjectbeta adrenergic receptor blocking agenten_US
dc.subjectdipeptidyl carboxypeptidase inhibitoren_US
dc.subjectanticoagulant agenten_US
dc.subjectcardiotonic agenten_US
dc.subjectdigoxinen_US
dc.subjectloop diuretic agenten_US
dc.subjectmineralocorticoid antagonisten_US
dc.subjectadulten_US
dc.subjectageden_US
dc.subjectall cause mortalityen_US
dc.subjectatrial fibrillationen_US
dc.subjectbleedingen_US
dc.subjectcardiovascular mortalityen_US
dc.subjectcerebrovascular accidenten_US
dc.subjectclinical outcomeen_US
dc.subjectembolismen_US
dc.subjectfemaleen_US
dc.subjecthumanen_US
dc.subjectischemic cardiomyopathyen_US
dc.subjectmajor clinical studyen_US
dc.subjectmaleen_US
dc.subjectnonischemic cardiomyopathyen_US
dc.subjectprescriptionen_US
dc.subjectpriority journalen_US
dc.subjectprospective studyen_US
dc.subjectregisteren_US
dc.subjectReviewen_US
dc.subjecttreatment outcomeen_US
dc.subjectatrial fibrillationen_US
dc.subjectcardiomyopathyen_US
dc.subjectcardiovascular diseaseen_US
dc.subjectcerebrovascular accidenten_US
dc.subjectcohort analysisen_US
dc.subjectcomparative studyen_US
dc.subjectcomplicationen_US
dc.subjectheart failureen_US
dc.subjectheart muscle ischemiaen_US
dc.subjectheart stroke volumeen_US
dc.subjectmiddle ageden_US
dc.subjectmortalityen_US
dc.subjectpathophysiologyen_US
dc.subjectpractice guidelineen_US
dc.subjectproportional hazards modelen_US
dc.subjectprotocol complianceen_US
dc.subjectvery elderlyen_US
dc.subjectAdrenergic beta-Antagonistsen_US
dc.subjectAgeden_US
dc.subjectAged, 80 and overen_US
dc.subjectAngiotensin Receptor Antagonistsen_US
dc.subjectAngiotensin-Converting Enzyme Inhibitorsen_US
dc.subjectAnticoagulantsen_US
dc.subjectAtrial Fibrillationen_US
dc.subjectCardiomyopathiesen_US
dc.subjectCardiotonic Agentsen_US
dc.subjectCardiovascular Diseasesen_US
dc.subjectCohort Studiesen_US
dc.subjectDigoxinen_US
dc.subjectFemaleen_US
dc.subjectGuideline Adherenceen_US
dc.subjectHeart Failureen_US
dc.subjectHemorrhageen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectMineralocorticoid Receptor Antagonistsen_US
dc.subjectMortalityen_US
dc.subjectMyocardial Ischemiaen_US
dc.subjectPlatelet Aggregation Inhibitorsen_US
dc.subjectPractice Guidelines as Topicen_US
dc.subjectProportional Hazards Modelsen_US
dc.subjectRegistriesen_US
dc.subjectSodium Potassium Chloride Symporter Inhibitorsen_US
dc.subjectStrokeen_US
dc.subjectStroke Volumeen_US
dc.titleAnalysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients with Atrial Fibrillation: A Report from the GARFIELD-AF Registryen_US
dc.typeReview Articleen_US

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