RT Journal Article
T1 Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation.
A1 Dominguez, Fernando
A1 Climent, Vicente
A1 Zorio, Esther
A1 Ripoll-Vera, Tomas
A1 Salazar-Mendiguchia, Joel
A1 Garcia-Pinilla, Jose Manuel
A1 Urbano-Moral, Jose Angel
A1 Fernandez-Fernandez, Xusto
A1 Lopez-Cuenca, David
A1 Ajo-Ferrer, Raquel
A1 Sanz-Sanchez, Jorge
A1 Gomez-Perez, Yolanda
A1 Lopez-Garrido, Miguel A
A1 Barriales-Villa, Roberto
A1 Gimeno, Juan Ramon
A1 Garcia-Pavia, Pablo
K1 Anticoagulation
K1 Atrial fibrillation
K1 Hypertrophic cardiomyopathy
AB Chronic anticoagulation with vitamin K antagonists (VKAs) is recommended in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF). Direct oral anticoagulants (NOACs) are an alternative to VKAs but there are limited data to support their use in HCM. We sought to describe the pattern of use, thromboembolic events, bleeding and quality of life in patients with HCM and AF treated with NOACs. Data from patients treated with NOACs (n=99) and VKA (n=433) at 9 inherited cardiac diseases units were retrospectively collected. Annual rates of embolic events, serious bleeding and death were analysed and compared. Quality of life and treatment satisfaction were evaluated with SF-36 and SAFUCA questionnaires in 80 NOAC-treated and 57 VKA-treated patients. After median follow-up of 63 months (IQR: 26-109), thromboembolic events (TIA/stroke and peripheral embolism) occurred in 10% of patients on oral anticoagulation. Major/clinically relevant bleeding occurred in 3.8% and the global mortality rate was 23.3%. Thromboembolic event rate was 0.62 per 100patient-years in the NOAC group vs. 1.59 in the VKA group [subhazard ratio (SHR) 0.32;95%CI:0.04-2.45; p=0.27]. Major/clinically relevant bleeding occurred in 0.62 per 100person-years in the NOAC group vs. 0.60 in the VKA group (SHR 1.28;95%CI 0.18-9.30; p=0.85). Quality of life scores were similar in both groups; however, NOAC-treated patients achieved higher scores in the SAFUCA. HCM patients with AF on NOACs showed similar embolic and bleeding rates to those on VKA. Although quality of life was similar in both groups, the NOAC group reported higher treatment satisfaction.
PB Elsevier Ireland Ltd.
YR 2017
FD 2017-08-07
LK http://hdl.handle.net/10668/11507
UL http://hdl.handle.net/10668/11507
LA en
NO Dominguez F, Climent V, Zorio E, Ripoll-Vera T, Salazar-Mendiguchía J, García-Pinilla JM, et al. Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation. Int J Cardiol. 2017 Dec 1;248:232-238.
DS RISalud
RD May 9, 2025