P281Baseline characteristics of patients with atrial fibrillation with and without comorbid heart failure: the GLORIA-AF registry

Abstract

Introduction: Heart failure (HF) and atrial fibrillation (AF) are among the most common cardiovascular conditions and frequently co-exist. There is ample evidence that AF and HF both have deleterious effects, and together they increase the risk of thromboembolic events more than additively. GLORIA-AF is a global registry programme of newly diagnosed non-valvular AF patients at risk of stroke, consecutively enrolled irrespective of antithrombotic treatment prescribed. Purpose: This analysis of patients enrolled in phase II of GLORIA-AF (which started after approval of dabigatran in the respective countries) aimed to compare baseline characteristics, comorbid diseases and co-medications in the subset with HF vs those without HF (NYHA class II-IV or ejection fraction ≤40%). Methods: Eligible patients were those who completed a baseline visit in phase II. Results: A total of 15,092 patients were included in the full baseline set. After excluding 149 due to missing data, 3647 AF patients were diagnosed with comorbid HF, while 11,296 did not have comorbid HF. There were regional differences in the prevalence of HF: 19.7% in North America, 23.4% in Europe, 27.3% in Asia, 30.3% in the Middle East/South Africa and 32.4% in Latin America. When compared with those without HF, patients with HF were more likely to be symptomatic; have a history of persistent or permanent AF, coronary artery disease or myocardial infarction; and have a CHA2DS2VASc score ≥2. There were no appreciable differences in the proportion of patients ≥75 years, and those with HAS BLED score ≥3 between the two groups (Figure). The use of antihypertensive, HF and antiarrhythmic medications was higher among HF patients: beta blockers (70.5 vs 56.9%, respectively), diuretics (67.4 vs 29.5%), digoxin (22.0 vs 8.0%), other antiarrhythmic drugs (8.9 vs 4.1%), angiotensin-converting enzyme inhibitors (45.1 vs 27.2%) and angiotensin receptor blockers (23.3 vs 24.9%). Overall anticoagulant treatment patterns were similar between patients with and without HF. Anticoagulant treatment was administered to 81.5% of patients with HF (non-vitamin K antagonist [VKA] oral anticoagulants [NOAC] 46.6% and VKA 34.9%) and 79.5% with no HF (NOAC 48.0% and VKA 31.5%) with regional differences. Conclusions: This analysis provides additional insights among newly diagnosed patients with non-valvular AF who have a comorbid diagnosis of HF. Such patients are more likely to have symptomatic and persistent/ permanent AF. Regional differences were observed with more patients in Asia, the Middle East and Latin America with an HF diagnosis than counterparts in North America or Europe. (Figure Presented).