Prognostic implications of valvular heart disease in patients with non-valvular atrial fibrillation

Table 2 Clinical outcomes according to VHD status

Study Outcomes	Significant VHD (n = 575)		No/mild VHD (n = 408)		Unadjusted		Adjusted^c
Study Outcomes	n	Incidence rate¹ (per 100 pt-yrs)	n	Incidence rate^a (per 100 pt-yrs)	HR (95% CI)^b	p value^d	HR (95% CI)^b	p value^d
All-cause death	277	21.6	79	6.5	3.24 (2.52–4.16)	< 0.001	1.55 (1.17–2.06)	0.02
Cardiovascular death	208	16.0	49	4.0	3.87 (2.83–5.29)	< 0.001	1.70 (1.09–2.66)	0.02
Stroke/systemic embolic event	25	2.1	14	1.2	1.77 (0.92–3.43)	0.089	1.80 (0.83–3.91)	0.136
Major bleeding	22	1.9	22	2.0	0.88 (0.49–1.59)	0.669	0.60 (0.29–1.24)	0.167
HF hospitalization	58	5.8	17	1.8	4.08 (2.37–7.04)	< 0.001	2.53 (1.35–4.73)	0.004
Any hospitalization	202	20.3	155	16.9	1.48 (1.20–1.84)	< 0.001	1.18 (0.92–1.52)	0.202
Net clinical outcomes
Cardiovascular death or stroke/SEE or major bleeding	239	22.9	81	8.8	2.72 (2.11–3.51)	< 0.001	1.30 (0.97–1.74)	0.079
Cardiovascular death or HF hospitalization	249	24.5	62	6.7	3.67 (2.78–4.85)	< 0.001	1.74 (1.19–2.55)	0.005
Cardiovascular death or Any hospitalization	369	36.6	192	20.9	1.76 (1.48–2.09)	< 0.001	1.20 (0.98–1.47)	0.077
All-cause death or HF hospitalization	316	31.3	92	9.9	3.17 (2.51–4.01)	< 0.001	1.61 (1.24–2.08)	< 0.001

^aIncidence rates are expressed per 100 patient-years. ^bHazard ratios and 95% CI are presented using a Cox proportional hazards regression. ^cAdjusted hazard ratio indicates adjustment for variables that were individually associated with each outcome, including age, gender, body mass index, AF pattern, duration of AF, heart failure, chronic obstructive pulmonary disease, coronary artery disease, prior myocardial infarction, prior stroke, prior major bleeding, estimated glomerular filtration rate, LVEF, LAVi, N-terminal pro B-type natriuretic peptide, high-sensitive cardiac troponin T, type of oral anticoagulation and rate or rhythm control strategy. ^dValues in bold indicate statistical significance (p < 0.05)
VHD valvular heart disease, SEE systemic embolic event, HF heart failure, CI confidence interval

ISSN: 1471-2261