Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/20494
Title
Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation
Author(s)
Dominguez, Fernando CNIC | Climent, Vicente | Zorio, Esther | Ripoll-Vera, Tomás | Salazar-Mendiguchia, Joel | Manuel Garcia-Pinilla, Jose | Angel Urbano-Moral, Jose | Fernandez-Fernandez, Xusto | Lopez-Cuenca, David | Ajo-Ferrer, Raquel | Sanz-Sanchez, Jorge | Gomez-Perez, Yolanda | Lopez-Garrido, Miguel A | Barriales-Villa, Roberto | Ramon Gimeno, Juan | Garcia-Pavia, Pablo CNIC
Date issued
2017-12-01
Citation
Dominguez Fernando, Climent Vicente, Zorio Esther, Ripoll-Vera Tomas, Salazar-Mendiguchia Joel, Manuel Garcia-Pinilla Jose, et al. Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation. Int J Cardiol. 2017 Dec 01;248:232-238. Epub 2017 Aug 7.
Language
Inglés
Document type
research article
Abstract
Background: Chronic anticoagulation with vitamin K antagonists (VKAs) is recommended in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF). Direct oral anticoagulants (NOACs) are an alternative to VKAs but there are limited data to support their use in HCM. We sought to describe the pattern of use, thromboembolic events, bleeding and quality of life in patients with HCM and AF treated with NOACs. Methods: Data from patients treated with NOACs (n = 99) and VKA (n = 433) at 9 inherited cardiac diseases units were retrospectively collected. Annual rates of embolic events, serious bleeding and death were analysed and compared. Quality of life and treatment satisfaction were evaluated with SF-36 and SAFUCA questionnaires in 80 NOAC-treated and 57 VKA-treated patients. Results: After median follow-up of 63 months (IQR: 26-109), thromboembolic events (TIA/stroke and peripheral embolism) occurred in 10% of patients on oral anticoagulation. Major/clinically relevant bleeding occurred in 3.8% and the global mortality rate was 23.3%. Thromboembolic event rate was 0.62 per 100 patient-years in the NOAC group vs. 1.59 in the VKA group [subhazard ratio (SHR) 0.32;95% CI: 0.04-2.45; p = 0.27]. Major/clinically relevant bleeding occurred in 0.62 per 100 person-years in the NOAC group vs. 0.60 in the VKA group (SHR 1.28;95% CI 0.18-9.30; p = 0.85). Quality of life scores were similar in both groups; however, NOAC-treated patients achieved higher scores in the SAFUCA. Conclusions: HCM patients with AF on NOACs showed similar embolic and bleeding rates to those on VKA. Although quality of life was similar in both groups, the NOAC group reported higher treatment satisfaction.
Subject
MESH
Aged | Administration, Oral | Follow-Up Studies | Humans | Cardiomyopathy, Hypertrophic | Middle Aged | Longitudinal Studies | Male | Atrial Fibrillation | Female | Cohort Studies | Anticoagulants | Retrospective Studies
DECS
Estudios de Cohortes | Femenino | Fibrilación Atrial | Masculino | Estudios de Seguimiento | Administración Oral | Cardiomiopatía Hipertrófica | Estudios Longitudinales | Humanos | Persona de Mediana Edad | Anciano | Estudios Retrospectivos | Anticoagulantes
Online version
DOI
Collections
- Investigación > IIS > IdisBa - Instituto de Investigación Sanitaria Illes Balears (Baleares)
- Investigación > IIS > IBIMA-Plataforma BIONAND - Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (Andalucía)
- Investigación > IIS > IBIS - Instituto de Biomedicina de Sevilla (Andalucía)
- Investigación > IIS > INIBIC - Instituto de Investigación Biomédica A Coruña (Galicia)
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