Outcomes of patients with atrial fibrillation on oral anticoagulation with and without heart failure: the ETNA-AF-Europe registry

doi:10.1093/europace/euad280

Arrhythmias & electrophysiologyCohort study

Outcomes of patients with atrial fibrillation on oral anticoagulation with and without heart failure: the ETNA-AF-Europe registry

EuropacePublished 15 Sep 2023

Prospective observational registry study
multicentre
4-year follow-up (2-year reported)

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Authors' conclusion

Anticoagulated patients with HF at baseline featured higher rates of major bleeding and all-cause death

Study context

Population: Edoxaban-treated patients with atrial fibrillation (AF), ETNA-AF-Europe registryLeft ventricular ejection fraction (LVEF) available in 82.4% of heart failure (HF)
Participants: 13,133 patients

Exposure: AF patients on edoxaban with vs without HF
HFn = 1,854
Outcome: Ischaemic stroke/TIA/SEE, major bleeding and mortality
Follow-up: 2-year follow-up

Main finding

As reported in the abstract

Any stroke/SEE and all-cause death · 2 years

HF

0.86%/year

Any stroke/systemic embolic events (SEE) · All-cause death 8.30%/year

No HF

0.67%/year

Any stroke/SEE · All-cause death 3.17%/year

all-cause death, multivariate Cox

Each group vs no HFHazard ratio (95% CI)

HF LVEF <40%

2.42(1.95–3.00)

HF LVEF ≥40%

1.80(1.45–2.23)

Observational data: associations, not effects.

Safety

Outcome	HF	No HF	Lower risk with HF ←→ Higher risk with HF	HR (95% CI)
Major bleeding · 2 years · multivariate Cox · annualized event rates	1.73%/year	0.86%/year		1.65 (1.20–2.26)
			0.512Hazard ratio (log scale)

Original publication

Outcomes of patients with atrial fibrillation on oral anticoagulation with and without heart failure: the ETNA-AF-Europe registry. Europace. Published 15 September 2023. doi:10.1093/europace/euad280

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Summarised from the published abstract; every number is checked against it