2026-04-14T08:22:33Zhttps://recercat.cat/oai/request

oai:recercat.cat:10230/613582025-12-13T21:18:30Zcom_2072_6col_2072_452952

Factors associated with disease progression in patients with atrial fibrillation and heart failure anticoagulated with rivaroxaban Manito Lorite, Nicolás Cepeda Rodrigo, José María Farré López, Núria Castillo Orive, Miguel Galve, Enrique Jiménez Candil, Javier García Pinilla, José M. López Sánchez, Eduardo Sebastián Rafols, Carles Gómez Doblas, Juan José Anticoagulation Atrial fibrillation Direct oral anticoagulant Heart failure Rivaroxaban Worsening heart failure Background: Patients with atrial fibrillation (AF) and heart failure (HF) have a high risk of thromboembolism and other outcomes and anticoagulation is recommended. Hypothesis: This study was aimed to explore the risk factors associated with HF worsening in patients with AF and HF taking rivaroxaban in Spain. Methods: Multicenter, prospective, observational study that included adults with AF and chronic HF, receiving rivaroxaban ≥4 months before entering. HF worsening was defined as first hospitalization or emergency visit because of HF exacerbation. Results: A total of 672 patients from 71 Spanish centers were recruited, of whom 658 (97.9%) were included in the safety analysis and 552 (82.1%) in the per protocol analysis. At baseline, mean age was 73.7 ± 10.9 years, 64.9% were male, CHA2 DS2 -VASc was 4.1 ± 1.5, HAS-BLED was 1.6 ± 0.9% and 51.3% had HF with preserved ejection fraction. After 24 months of follow-up, 24.9% of patients developed HF worsening, 11.6% died, 2.9% had a thromboembolic event, 3.1% a major bleeding, 0.5% an intracranial bleeding and no patient had a fatal hemorrhage. Older age, the history of chronic obstructive pulmonary disease, the previous use of vitamin K antagonists, and restrictive or infiltrative cardiomyopathies, were independently associated with HF worsening. Only 6.9% of patients permanently discontinued rivaroxaban treatment. Conclusions: Approximately one out of four patients with HF and AF treated with rivaroxaban developed a HF worsening episode after 2 years of follow-up. The identification of those factors that increase the risk of HF worsening could be helpful in the comprehensive management of this population. 2024-10-09T06:25:04Z 2024-10-09T06:25:04Z 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Clin Cardiol. 2024 Feb;47(2):e24189 © 2023 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Wiley