TY - JOUR
T1 - Atrial fibrillation and comorbidities
T2 - Clinical characteristics and antithrombotic treatment in GLORIA-AF
AU - Kozieł, Monika
AU - Teutsch, Christine
AU - Halperin, Jonathan L.
AU - Rothman, Kenneth J.
AU - Diener, Hans Christoph
AU - Ma, Chang Sheng
AU - Marler, Sabrina
AU - Lu, Shihai
AU - Gurusamy, Venkatesh K.
AU - Huisman, Menno V.
AU - Lip, Gregory Y.H.
N1 - Publisher Copyright:
© 2021 Koziel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2021/4
Y1 - 2021/4
N2 - Background Patients with AF often have multimorbidity (the presence of ≥2 concomitant chronic conditions). Objective To describe baseline characteristics, patterns of antithrombotic therapy, and factors associated with oral anticoagulant (OAC) prescription in patients with AF and ≥2 concomitant, chronic, comorbid conditions. Methods Phase III of the GLORIA-AF Registry enrolled consecutive patients from January 2014 through December 2016 with recently diagnosed AF and CHA2DS2-VASc score ≥1 to assess the safety and effectiveness of antithrombotic treatment. Results Of 21,241 eligible patients, 15,119 (71.2%) had ≥2 concomitant, chronic, comorbid conditions. The proportions of patients with multimorbidity receiving non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKA) were 60.2% and 23.6%, respectively. The proportion with paroxysmal AF was 57.0% in the NOAC group and 45.4% in the VKA group. Multivariable log-binomial regression analysis found the following factors were associated with no OAC prescription: Pattern of AF (paroxysmal, persistent, or permanent), coronary artery disease, myocardial infarction, prior bleeding, smoking status, and region (Asia, North America, or Europe). Factors associated with OAC prescriptions were age, body mass index, renal function, hypertension, history of cerebral ischemic symptoms, and AF ablation. Conclusion Multimorbid AF patients prescribed NOACs have fewer comorbidities than those prescribed VKAs. Age, AF pattern, comorbidities, and renal function are associated with OAC prescription.
AB - Background Patients with AF often have multimorbidity (the presence of ≥2 concomitant chronic conditions). Objective To describe baseline characteristics, patterns of antithrombotic therapy, and factors associated with oral anticoagulant (OAC) prescription in patients with AF and ≥2 concomitant, chronic, comorbid conditions. Methods Phase III of the GLORIA-AF Registry enrolled consecutive patients from January 2014 through December 2016 with recently diagnosed AF and CHA2DS2-VASc score ≥1 to assess the safety and effectiveness of antithrombotic treatment. Results Of 21,241 eligible patients, 15,119 (71.2%) had ≥2 concomitant, chronic, comorbid conditions. The proportions of patients with multimorbidity receiving non-vitamin K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKA) were 60.2% and 23.6%, respectively. The proportion with paroxysmal AF was 57.0% in the NOAC group and 45.4% in the VKA group. Multivariable log-binomial regression analysis found the following factors were associated with no OAC prescription: Pattern of AF (paroxysmal, persistent, or permanent), coronary artery disease, myocardial infarction, prior bleeding, smoking status, and region (Asia, North America, or Europe). Factors associated with OAC prescriptions were age, body mass index, renal function, hypertension, history of cerebral ischemic symptoms, and AF ablation. Conclusion Multimorbid AF patients prescribed NOACs have fewer comorbidities than those prescribed VKAs. Age, AF pattern, comorbidities, and renal function are associated with OAC prescription.
UR - http://www.scopus.com/inward/record.url?scp=85104128697&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0249524
DO - 10.1371/journal.pone.0249524
M3 - Article
C2 - 33852611
AN - SCOPUS:85104128697
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 4 April
M1 - e0249524
ER -