Arrhythmias & electrophysiologySecondary analysis
Clinical complexity in patients with atrial fibrillation: exploring differential risk profiles from European and Asian cohorts
- Post hoc analysis of the EORP-AF and APHRS-AF registries
Authors' conclusion
Among AF patients with CC, those enrolled in Asia exhibited marked differences in clinical profiles, management strategies, and outcomes, suggesting greater vulnerability to CC in the Asian population.
Study context
- Population
- Patients with atrial fibrillation (AF) in European (EORP-AF) and Asian (APHRS-AF) registries2,794 (19.9%) met clinical complexity (CC) criteria
- Participants
- 14,055 patients
- Comparison
- Clinical complexity vs no CC in AF
- CCn = 2,794
- Primary endpoint
- Composite of:
- All-cause death
- Major adverse cardiovascular events (MACE) (CV death, ACS, thromboembolic events)
Primary result
Composite of:
Hazard ratio
1.55
95% CI 1.35–1.77
CC vs No CC
HR 1.55 (95% CI 1.35–1.77)
As reported in the abstract
Secondary outcomes
| Outcome | Estimate | |
|---|---|---|
| All-cause death | HR 1.65 (95% CI 1.42–1.93) | |
| MACE | HR 1.50 (95% CI 1.26–1.80) | |
| CV death | HR 1.81 (95% CI 1.40–2.36) | |
| OAC use and rhythm control in patients with CC, Asian vs European — Asian vs European · OAC use | OR 0.75 (95% CI 0.57–1.01) | |
| OAC use and rhythm control in patients with CC, Asian vs European — Asian vs European · rhythm control | OR 0.53 (95% CI 0.41–0.69) | |
| 0.512Ratio (log scale) |
Composite outcome, by region (subgroup)
- Excess risk of composite outcome in Asians
- HR 2.28 (1.57-3.32) (95% CI)
- Excess risk of composite outcome in Europeans
- HR 1.51 (1.31-1.75) (95% CI)
- P-interaction = 0.036
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Major bleeding | 2.02 (1.47–2.77) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Clinical complexity in patients with atrial fibrillation: exploring differential risk profiles from European and Asian cohorts. Europace. Published 19 September 2025. doi:10.1093/europace/euaf229
Summarised from the published abstract; every number is checked against it