Inadequate anticoagulation by Vitamin K Antagonists is associated with Major Adverse Cardiovascular Events in patients with atrial fibrillation

International Journal of Cardiology
Daniele PastoriFrancesco Violi

Abstract

Time in therapeutic range (TTR) reflects the quality of anticoagulation and is inversely correlated with ischemic stroke in atrial fibrillation (AF) patients. Few data on the relationship between TTR and myocardial infarction (MI) are available. We investigated the association between TTR and Major Adverse Cardiovascular Events (MACE) in a cohort of anticoagulated AF patients. We calculated TTR for 627 AF patients on vitamin K antagonists, who were followed for a median of 30.8 months (1755 patients/year). The primary outcome was a combined endpoint of MACE including fatal/nonfatal MI and cardiovascular death. Mean age was 73.3 (±8.2) years, and 40.2% were women. During follow-up, we recorded 67 events: 19 stroke/TIA (1.1%/year) and 48 MACE (2.9%/year): 24 MI and 24 cardiovascular deaths. The cohort was categorized according to tertiles of TTR values: TTR 13-58%, 59-74%, and 75-100%. There was a significant increased rate of MACE across tertiles of TTR (Log-Rank test: p<0.001). On Cox proportion hazard analysis, the 2nd vs. 1st tertile of TTR (p=0.002, hazard ratio [HR] 0.347, confidence interval [CI] 95% 0.177-0.680), 3rd vs. 1st tertile of TTR (p<0.001, HR 0.164, CI 95% 0.067-0.402), age (p<0.001, HR 1.094, CI 95% 1.042-1.148...Continue Reading

Associated Clinical Trials

Jun 20, 2013·Pasquale Pignatelli

References

Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Nov 2, 2002·BMJ : British Medical Journal·Gregory Y H LipDwayne S G Conway
Apr 22, 2005·Journal of Thrombosis and Haemostasis : JTH·S SchulmanUNKNOWN Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on T
Mar 4, 2010·Internal and Emergency Medicine·Licia PolimeniFrancesco Violi
Sep 30, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·A John CammUNKNOWN ESC Committee for Practice Guidelines
Dec 20, 2012·Circulation. Arrhythmia and Electrophysiology·Francesco Violi, Lorenzo Loffredo
May 9, 2013·International Journal of Cardiology·Roberto CangemiUNKNOWN ARA PACIS study group
Oct 22, 2013·Vascular Health and Risk Management·Andreas ClemensJeffrey Friedman
Nov 6, 2013·JAMA Internal Medicine·Elsayed Z SolimanMary Cushman
Dec 1, 2012·Global Heart·Kristian ThygesenHarvey D White

❮ Previous
Next ❯

Citations

Nov 20, 2015·Atherosclerosis·Daniele PastoriPasquale Pignatelli
Oct 17, 2015·Internal and Emergency Medicine·Daniele PastoriFrancesco Violi
Nov 26, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Xingshun QiXiaozhong Guo
Dec 8, 2016·Expert Opinion on Pharmacotherapy·Francisco MarínMarcelo Sanmartín
Feb 10, 2018·European Journal of Clinical Investigation·Inmaculada Roldán RabadánUNKNOWN FANTASIIA Study Investigators
May 22, 2016·Journal of the American Heart Association·Francesco VioliDaniele Pastori
Aug 4, 2016·Oncotarget·Leiliane Rodrigues MarcattoPaulo Caleb Junior Lima Santos
Aug 9, 2017·Expert Opinion on Pharmacotherapy·Walter AgenoAndrea Rubboli
Sep 9, 2020·European Journal of Clinical Investigation·Danilo MenichelliUNKNOWN CAR
Feb 23, 2020·British Journal of Haematology·Daniele PastoriUNKNOWN Italian Federation of Anticoagulation Clinics (FCSA)
Jun 27, 2020·International Journal of Cancer. Journal International Du Cancer·Daniele PastoriUNKNOWN ATHERO-AF study group
Jul 27, 2018·Research and Practice in Thrombosis and Haemostasis·John K Bartoli-AbdouVivian Auyeung
Mar 28, 2019·Frontiers in Cardiovascular Medicine·Daniele PastoriFrancesco Violi
Jun 30, 2019·Scandinavian Cardiovascular Journal : SCJ·Joana Alves-FerreiraSandrina F Braga
Mar 20, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Daniele PastoriGregory Y H Lip
Mar 28, 2018·Internal and Emergency Medicine·Valeria RaparelliUNKNOWN ARAPACIS Study Collaborators
Oct 21, 2020·International Journal of Clinical Practice·Danilo MenichelliUNKNOWN ATHERO-AF study group
Feb 4, 2021·International Journal of Clinical Practice·Daniele PastoriUNKNOWN Italian Federation of Anticoagulation Clinics (FCSA)
Apr 4, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Danilo Menichelli The Italian Federation Of Anticoagulation Clinics Fcsa

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.