Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology

Katarzyna Mizia-Stec (1) , Alida L.P. Caforio (2) , Philippe Charron (3) , Juan R Gimeno , Perry Elliott (4) , Juan Pablo Kaski (5) , Aldo P Maggioni , Luigi Tavazzi , Angelos G Rigopoulos (6) , Cecile Laroche , Attila Frigy , Elisabetta Zachara , Maria Luisa Pena-Pena (7) , Akinsanya Olusegun-Joseph (8) , Yigal Pinto (9) , Simone Sala (10) , Fabrizio Drago (11) , Olga Blagova (12) , Elena Reznik , Michał Tendera (1)

1 Silesian Medical University, Katowice, Poland
2 Unipd - Università degli Studi di Padova = University of Padua
3 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
4 UCL - University College of London [London]
5 GOSH - Great Ormond Street Hospital for Children [London]
6 Martin-Luther-University Halle-Wittenberg
7 Hospital Universitario Virgen del Rocío [Sevilla]
8 University of Lagos
9 AMC - Academic Medical Center - Academisch Medisch Centrum [Amsterdam]
10 Ospedale San Raffaele
11 IRCCS Ospedale Pediatrico Bambino Gesù = Bambino Gesù Children’s Hospital
12 Sechenov First Moscow State Medical University

Aims: Cardiomyopathies are a heterogeneous group of disorders that increase the risk for atrial fibrillation (AF). The aim of the study is to assess the prevalence of AF, anticoagulation management, and risk of stroke/transient ischaemic attack (TIA) in patients with cardiomyopathy. Methods and results: Three thousand two hundred eight consecutive adult patients with cardiomyopathy (34.9% female; median age: 55.0 years) were prospectively enrolled as part of the EURObservational Research Programme Cardiomyopathy/Myocarditis Registry. At baseline, 903 (28.2%) patients had AF (29.4% dilated, 27.5% hypertrophic, 51.5% restrictive, and 14.7% arrhythmogenic right ventricular cardiomyopathy, P < 0.001). AF was associated with more advanced New York Heart Association class (P < 0.001), increased prevalence of cardiovascular risk factors and co-morbidities, and a history of stroke/TIA (P < 0.001). Oral anticoagulation was administered in 71.7% of patients with AF (vitamin K antagonist: 51.6%; direct oral anticoagulant: 20.1%). At 1 year follow-up, the incidence of cardiovascular endpoints was as follows: stroke/TIA 1.85% (AF vs. non-AF: 3.17% vs. 1.19%, P < 0.001), death from any cause 3.43% (AF vs. non-AF: 5.39% vs. 2.50%, P < 0.001), and death from heart failure 1.67% (AF vs. non-AF: 2.44% vs. 1.31%, P = 0.033). The independent predictors for stroke/TIA were as follows: AF [odds ratio (OR) 2.812, P = 0.005], history of stroke (OR 7.311, P = 0.010), and anaemia (OR 3.119, P = 0.006). Conclusions: The study reveals a high prevalence and diverse distribution of AF in patients with cardiomyopathies, inadequate anticoagulation regimen, and high risk of stroke/TIA in this population.

Mots clés: Hypertrophic cardiomyopathy; Dilated cardiomyopathy; Restrictive cardiomyopathy; Arrhythmogenic right ventricular cardiomyopathy; Atrial fibrillation; Anticoagulation

Domaines: Sciences du Vivant [q-bio]

Katarzyna Mizia-Stec, Alida L.P. Caforio, Philippe Charron, Juan R Gimeno, Perry Elliott, et al.. Atrial fibrillation, anticoagulation management and risk of stroke in the Cardiomyopathy/Myocarditis registry of the EURObservational Research Programme of the European Society of Cardiology. ESC Heart Failure, 2020, ⟨10.1002/ehf2.12854⟩. ⟨hal-02945489⟩