Clinical InvestigationElectrophysiologyGuideline-adherent antithrombotic treatment is associated with improved outcomes compared with undertreatment in high-risk patients with atrial fibrillation. The Euro Heart Survey on Atrial Fibrillation☆,
Section snippets
Methods
In the Euro Heart Survey on AF (2003-2004), 5333 ambulant and hospitalized patients with AF were enrolled in cardiology practices. Details of the baseline survey have previously been described.7 Patients were enrolled if they were 18 years or older and if they had an electrocardiogram or Holter recording showing AF during the qualifying admission/consultation or in the preceding 12 months. Patients with only atrial flutter on their electrocardiograms were excluded. Data were collected through
Results
In the initial survey, data on stroke risk profile and antithrombotic drug therapy at discharge were available for 5130 patients who were alive at the end of the baseline visit. Of these patients, survival status at 1-year follow-up was known for 4086 patients (80%). Compared with patients with complete follow-up data, patients for whom no follow-up data were available were enrolled more often at the cardiology ward (65% vs 54%; P < .001) instead of the outpatient clinic (21% vs 37%; P < .001),
Discussion
The Euro Heart Survey on AF is the first observational study to show that antithrombotic undertreatment is associated with worse cardiovascular outcome compared to guideline adherence. Overtreatment was not associated with a significant increase in bleeding risk.
Acknowledgement
Central data collection was done at the European Heart House of the European Society of Cardiology, Sophia Antipolis, France. Data analysis was done at the Department of Cardiology, University Hospital Maastricht, Maastricht, the Netherlands. We thank the Euro Heart Survey team, national coordinators, investigators, and data collection officers for performing the survey.
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This study was supported by AstraZeneca (London, United Kingdom), Sanofi-Aventis, and Eucomed (Brussels, Belgium), and by the following institutions: Austrian Heart Foundation (Vienna, Austria), Austrian Society of Cardiology (Vienna, Austria), French Federation of Cardiology (Paris, France), Hellenic Cardiological Society (Athens, Greece), Netherlands Heart Foundation (Hague, The Netherlands), Portuguese Society of Cardiology (Lisbon, Portugal), Spanish Cardiac Society (Madrid, Spain), and the Swedish Heart and Lung Foundation (Stockholm, Sweden).
No other affiliations and no conflict of interest reported.