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00925njm 22002777a 4500 dc Dominguez, Fernando author Climent, Vicente author Zorio, Esther author Ripoll-Vera, Tomás author Salazar-Mendiguchia, Joel author Manuel Garcia-Pinilla, Jose author Angel Urbano-Moral, Jose author Fernandez-Fernandez, Xusto author Lopez-Cuenca, David author Ajo-Ferrer, Raquel author Sanz-Sanchez, Jorge author Gomez-Perez, Yolanda author Lopez-Garrido, Miguel A author Barriales-Villa, Roberto author Ramon Gimeno, Juan author Garcia-Pavia, Pablo author 2017-12-01 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. 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. 10.1016/j.ijcard.2017.08.010 1874-1754 0167-5273 International Journal of Cardiology http://hdl.handle.net/20.500.13003/9544 28811092 L618025302 2-s2.0-85028311720 http://hdl.handle.net/20.500.12105/20494 411439900045 Hypertrophic cardiomyopathy Atrial fibrillation Anticoagulation Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation