Kirchhof, P; Haas, S; Amarenco, P; Turpie, AGG; Bach, M; Lambelet, M; Hess, S; Camm, AJ
(2024)
Causes of death in patients with atrial fibrillation anticoagulated with rivaroxaban: a pooled analysis of XANTUS.
Europace, 26 (7).
euae183.
ISSN 1532-2092
https://doi.org/10.1093/europace/euae183
SGUL Authors: Camm, Alan John
Abstract
AIMS: Anticoagulation can prevent stroke and prolong lives in patients with atrial fibrillation (AF). However, anticoagulated patients with AF remain at risk of death. The aim of this study was to investigate the causes of death and factors associated with all-cause and cardiovascular death in the XANTUS population. METHODS AND RESULTS: Causes of death occurring within a year after rivaroxaban initiation in patients in the XANTUS programme studies were adjudicated by a central adjudication committee and classified following international guidance. Baseline characteristics associated with all-cause or cardiovascular death were identified. Of 11 040 patients, 187 (1.7%) died. Almost half of these deaths were due to cardiovascular causes other than bleeding (n = 82, 43.9%), particularly heart failure (n = 38, 20.3%) and sudden or unwitnessed death (n = 24, 12.8%). Fatal stroke (n = 8, 4.3%), which was classified as a type of cardiovascular death, and fatal bleeding (n = 17, 9.1%) were less common causes of death. Independent factors associated with all-cause or cardiovascular death included age, AF type, body mass index, left ventricular ejection fraction, hospitalization at baseline, rivaroxaban dose, and anaemia. CONCLUSION: The overall risk of death due to stroke or bleeding was low in XANTUS. Anticoagulated patients with AF remain at risk of death due to heart failure and sudden death. Potential interventions to reduce cardiovascular deaths in anticoagulated patients with AF require further investigation, e.g. early rhythm control therapy and AF ablation. TRIAL REGISTRATION NUMBERS: NCT01606995, NCT01750788, NCT01800006.
Item Type: |
Article
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Additional Information: |
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
Keywords: |
Heart failure, Mortality, Rivaroxaban, Stroke, Sudden death, Humans, Atrial Fibrillation, Rivaroxaban, Female, Male, Aged, Cause of Death, Factor Xa Inhibitors, Risk Factors, Hemorrhage, Stroke, Middle Aged, Aged, 80 and over, Treatment Outcome, Heart Failure, Time Factors, Risk Assessment, Anticoagulants, Humans, Atrial Fibrillation, Hemorrhage, Anticoagulants, Treatment Outcome, Cause of Death, Risk Assessment, Risk Factors, Time Factors, Aged, Aged, 80 and over, Middle Aged, Female, Male, Heart Failure, Stroke, Factor Xa Inhibitors, Rivaroxaban, Heart failure, Mortality, Rivaroxaban, Stroke, Sudden death, 1103 Clinical Sciences, Cardiovascular System & Hematology |
SGUL Research Institute / Research Centre: |
Academic Structure > REF 2021 user group |
Journal or Publication Title: |
Europace |
ISSN: |
1532-2092 |
Language: |
eng |
Dates: |
Date | Event |
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2 July 2024 | Published | 29 June 2024 | Published Online | 7 June 2024 | Accepted |
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Publisher License: |
Creative Commons: Attribution-Noncommercial 4.0 |
Projects: |
Project ID | Funder | Funder ID |
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UNSPECIFIED | Bayer AG | UNSPECIFIED |
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PubMed ID: |
38941511 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/116652 |
Publisher's version: |
https://doi.org/10.1093/europace/euae183 |
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