Abstract 16257: Is the Risk of Stroke and Death Really Different in Patients With Non Valvular Atrial Fibrillation and Flutter?
Purpose: Little and conflicting data exist regarding cardiovascular risks among non valvular atrial fibrillation (NVAF) and flutter (NVAFl) patients. This study aims to assess whether patient characteristics and risk factors, including CHA2DS2-VASc could identify patients with NVAF or NVAFl at higher risk for stroke and death.
Methods: Between 1998 and 2011, 1,443 consecutive patients, hospitalised for NVAF or NVAFl were enrolled in the study. All patients were followed-up for at least six months. Cardiovascular events were recorded. The endpoint was defined as first occurrence of stroke or death. Kaplan-Meier (KM) survival curves estimates were compared using the Log Rank test. Association between arrhythmia type and outcome was evaluated using Cox models adjusted on all parameters defining the CHA2DS2-VASc score and treatments at discharge.
Results: At admission, 151 patients presented NVAFl and 1,292 NVAF. The groups differed by age, sex, cardiovascular risk factors, and history of AF. The NVAFl patients were younger (26% vs. 37% were aged ≥75 years, p=0.003) and more frequently men (80% vs. 55%, p<0.0001). Both groups had similar proportions of patients with CHA2DS2-VASc score ≥ 2 (100 (66%) NVAFl and 945 (73%) NVAF, p=0.186). During a mean follow-up of 4.7±3.5 years, events occurred in 57 (38%) NVAFl and 409 (32%) NVAF patients. As shown in the KM curves (figure), risk of stroke and death in both populations was similar irrespective of the CHA2DS2-VASc score. The adjusted Cox model found a hazard ratio of 1.26 (95%CI: 0.94-1.68, p=0.117) for NVAFl compared to NVAF.
Conclusion: These results suggest that patients with non valvular atrial fibrillation or flutter have similar stroke and death risk at mid-term follow-up.
Author Disclosures: S. Lang: None. L. Boyer-Chatenet: None. S. Ederhy: None. L. Soulat-Dufour: None. C. Van der Vynckt: None. S. Adavane: None. N. Haddour: None. B. Franck: None. A. Cohen: None.
- © 2014 by American Heart Association, Inc.