Abstract
Abstract 4392
Atrial fibrillation (AF) is the most common cardiac rhythm disorder and an independent risk factor for stroke. It′s prevalence in AF pts without oral anticoagulation (OA) is 1 to 12%. OA is recommended in all valvular AF pts and in non valvular AF pts associated with other risk factors for stroke (CHADS2 score >1).
to evaluate characteristics, evolution and incidence of thrombosis and bleeding in pts with AF under OA for at least 3 months.
we retrospectively analyzed 850 pts between Jan 2003 and Jan 2010.
the mean follow-up was 25 months (range 3–169). The features of the entire group are listed in the table below:
| Mean age (years, range) | 71 (22–97) |
| Age >74 years | 384 (45.1%) |
| Male gender | 476 (56%) |
| Valvular AF | 413/624 (66%) |
| Previous thrombosis | 109 (12.8%) |
| Diabetes | 118 (13.9%) |
| Arterial Hypertension | 401 (47.1%) |
| Dilated cardiomyopathy | 209/587 (35.6%) |
| Ejection fraction <30 | 137/655 (20.9%) |
| Mega atrium | 172/609 (28.2%) |
| Hypertiroidism | 157 (18.5%) |
| Coronary disease | 173 (20.4%) |
| Admissions to hospital | 57 (6.7%) |
| Creatinin ≥ 2 | 63 (7.4%) |
| Median INR | 2.42 |
| Controls between INR 2-3 | 59.5% |
| Mean age (years, range) | 71 (22–97) |
| Age >74 years | 384 (45.1%) |
| Male gender | 476 (56%) |
| Valvular AF | 413/624 (66%) |
| Previous thrombosis | 109 (12.8%) |
| Diabetes | 118 (13.9%) |
| Arterial Hypertension | 401 (47.1%) |
| Dilated cardiomyopathy | 209/587 (35.6%) |
| Ejection fraction <30 | 137/655 (20.9%) |
| Mega atrium | 172/609 (28.2%) |
| Hypertiroidism | 157 (18.5%) |
| Coronary disease | 173 (20.4%) |
| Admissions to hospital | 57 (6.7%) |
| Creatinin ≥ 2 | 63 (7.4%) |
| Median INR | 2.42 |
| Controls between INR 2-3 | 59.5% |
Minor bleeding was observed in 32.7% of the entire group (278/850) and major bleeding in 2.7% (23/850). Most of the major bleedings occurred at the gastrointestinal tract, and 53% of those pts presented INR <2 (8/15). Fatal bleeding (located at CNS) developed in 0.2% (2/850). Ten pts developed thrombosis during the follow-up period (1.17%); 50% of them with INR < 2.
45% of the pts were older than 74 years and most of them disclosed valvular AF. Minor bleeding was 15.4%/year, major bleeding: 1%/year, and thrombosis: 0.42%/year, according to the current literature.
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
