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).

Objective:

to evaluate characteristics, evolution and incidence of thrombosis and bleeding in pts with AF under OA for at least 3 months.

Methods:

we retrospectively analyzed 850 pts between Jan 2003 and Jan 2010.

Results:

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% 
View Large

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.

Conclusion:

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.

Disclosures:

No relevant conflicts of interest to declare.

Topics:
anticoagulation, atrial fibrillation, follow-up, brachial plexus neuritis, hemorrhage, international normalized ratio, thrombosis, cerebrovascular accident, ischemic stroke, cardiac arrhythmia

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2010 by The American Society of Hematology
2010
Sign in via your Institution