Background: Peripheral arterial disease has been linked with worse outcomes in patients with atrial fibrillation. The aim of this study is to assess the impact of peripheral arterial disease on mortality and stroke in a cohort of patients with atrial fibrillation.
Methods: This was an ancillary analysis of the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial. A comparison of baseline characteristics was made between patients with atrial fibrillation with and without diagnosed peripheral arterial disease. Multivariate cox regression analysis was performed to compare the risk of stroke, death, and cardiovascular death among the two groups.
Results: The prevalence of peripheral arterial disease in the whole cohort of 4060 patients with atrial fibrillation was 6.7%. Patients with peripheral arterial disease tended to be older; had higher prevalence of diabetes mellitus, hypertension, and smoking; and were more likely to have a history of coronary artery disease, heart failure, cardiac surgery or cardiac intervention, and stroke or transient ischemic attack (all P < .05). After multivariate adjustment, peripheral arterial disease was significantly associated with overall higher mortality (hazard ratio 1.34, 95% confidence interval 1.06-1.70, P = .016) in patients with atrial fibrillation, but the rates of ischemic stroke were similar in the two groups (3.9% vs 3.5%, P = 0.874). Subgroup analysis confined to the patients with non-anticoagulated atrial fibrillation showed that peripheral arterial disease was an independent predictor of ischemic stroke (hazard ratio 3.37, 95% confidence interval 1.25-9.09, P < .016).
Conclusion: Peripheral arterial disease predicts higher mortality in atrial fibrillation, and was an independent predictor of ischemic stroke in patients with non-anticoagulated atrial fibrillation. Proactive surveillance and optimization of medical management in this group of patients is warranted, given the high risks associated with peripheral arterial disease where atrial fibrillation is also present.
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http://dx.doi.org/10.1016/j.amjmed.2020.08.026 | DOI Listing |
J Endovasc Ther
January 2025
Angiology, HFR Fribourg, Hôpital Universitaire et Cantonal, Fribourg, Switzerland.
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View Article and Find Full Text PDFAbdom Radiol (NY)
January 2025
Department of Radiology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute,. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, 610000, Chengdu, China.
Objective: This study evaluates the potential of dual-energy CT (DECT) for preoperative prediction of tumor budding (TB) and lymphovascular invasion (LVI) in colon cancer.
Methods: This prospective study enrolled 153 patients (mean age 61.33 years ± 0.
J Oral Maxillofac Surg
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Professor, Private Practice, Proimtech A.Ş., Istanbul, Turkey.
Background: Postoperative nausea and vomiting (PONV) after orthognathic surgery remains one of the most common side effects despite the use of several medications.
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Introduction: In 2015, Society for Vascular Surgery guidelines on claudication management were released spanning optimal medical management, procedural, and post-procedure recommendations. Uptake of guidelines and changes to clinical practice over time remain unknown. This study hypothesized that guideline aligned practice increased after guideline release.
View Article and Find Full Text PDFDiagn Microbiol Infect Dis
January 2025
Department of Radiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, 46 rue Henri Huchard, 75018 Paris, France; INSERM U1148, Paris, France; Paris University, Paris, France. Electronic address:
Unusual course of Serratia marcescens (SM) infectious endocarditis (IE) and literature review (2016-2024; 26 cases). A 44-year-old man, with chronic venous ulcers, presented 21/2 years after a MSSA tricuspid valve IE, a tricuspid and aortic valves SM IE . After 6 weeks of antibiotherapy (meropenem i.
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