Abstract 5796: Unique Atrial Fibrillation Subpopulations: Thromboembolic Destination Predicts Recurrence Rates and Survival
Aim. Thromboembolic presentation (stroke, mesenteric or limb ischemia) in non-valvular atrial fibrillation may occur randomly or may identify unique subpopulations of patients with this dysrhythmia. The aim of this study was to determine whether future major adverse cardiovascular event rates (myocardial infarction, stroke, peripheral arterial embolism, death) differ between patients with peripheral embolism (AFPE) compared to those suffering stroke (AFS).
Methods. An inception cohort (1995–2005) with AFPE (n=216) were compared to randomly selected AFS patients (n=241).
Results. Patients with AFPE were older than AFS patients (79±10 vs 73±13 years; p<0.001) with a greater percentage of women (71% vs 45%; p<0.001). The most common presentation of AFPE patients was limb ischemia (90%). Except for prior stroke, all CHADS-2 variables were more prevalent in AFPE (Table⇓). During 3.3±3.6 years of follow up, survival was lower in AFPE compared to either AFS (p<0.001) or age/gender matched controls (p<0.001; Figure⇓). AFPE patients had lower survival free from recurrent embolization compared to AFS (82% vs 100%; p=0.005). Recurrence free survival for MI and stroke were similar.
Conclusions. Patients with peripheral embolization represent a unique subset of non-valvular atrial fibrillation with an increased risk of recurrence and high mortality rates compared to those suffering stroke.