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Eur J Vasc Endovasc Surg. 2010 Jul;40(1):9-16. doi: 10.1016/j.ejvs.2010.03.003. Epub 2010 Apr 10.

Prognosis of atrial fibrillation in patients with symptomatic peripheral arterial disease: data from the REduction of Atherothrombosis for Continued Health (REACH) Registry.

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  • 1Department of Vascular Surgery, Erasmus Medical Center, Room H 805, Erasmus MC, 's Gravendijkwal 230, 3015 GD Rotterdam, The Netherlands.

Abstract

BACKGROUND:

Atrial fibrillation (AF) is a significant risk factor for cardiovascular (CV) mortality. This study aims to evaluate the prognostic implication of AF in patients with peripheral arterial disease (PAD).

METHODS:

The International Reduction of Atherothrombosis for Continued Health (REACH) Registry included 23,542 outpatients in Europe with established coronary artery disease, cerebrovascular disease (CVD), PAD and/or > or =3 risk factors. Of these, 3753 patients had symptomatic PAD. CV risk factors were determined at baseline. Study end point was a combination of cardiac death, non-fatal myocardial infarction (MI) and stroke (CV events) during 2 years of follow-up. Cox regression analysis adjusted for age, gender and other risk factors (i.e., congestive heart failure, coronary artery re-vascularisation, coronary artery bypass grafting (CABG), MI, hypertension, stroke, current smoking and diabetes) was used.

RESULTS:

Of 3753 PAD patients, 392 (10%) were known to have AF. Patients with AF were older and had a higher prevalence of CVD, diabetes and hypertension. Long-term CV mortality occurred in 5.6% of patients with AF and in 1.6% of those without AF (p<0.001). Multivariable analyses showed that AF was an independent predictor of late CV events (hazard ratio (HR): 1.5; 95% confidence interval (CI): 1.09-2.0).

CONCLUSION:

AF is common in European patients with symptomatic PAD and is independently associated with a worse 2-year CV outcome.

Copyright 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

PMID:
20385507
[PubMed - indexed for MEDLINE]
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