Adverse outcomes in patients with atrial fibrillation and peripheral arterial disease: a report from the EURObservational research programme pilot survey on atrial fibrillation
Open accessAbstract
AIMS: Peripheral arterial disease (PAD) is highly prevalent in general population. Data on the prevalence of symptomatic PAD in patients with atrial fibrillation (AF) are limited, and the impact of PAD on adverse outcomes in AF patients is controversial. Our aims were: (i) to define the prevalence of symptomatic PAD in European AF patients and describe its associated clinical risk factors and (ii) to establish the relationship of PAD to adverse events in AF, especially all-cause death. METHODS AND RESULTS: Atrial fibrillation patients enrolled in the EORP-AF Pilot study with data about PAD status were included in this analysis. Event rates were determined at 1-year follow-up. Peripheral arterial disease was recorded in 328 (11%) patients. Age (P < 0.0001), hypertension (P = 0.0059), diabetes mellitus (P = 0.0001), chronic heart failure (P < 0.0001), previous stroke/transient ischaemic attack (P = 0.0060), and antiplatelet drug treatment (P = 0.0001) were associated with the presence of PAD, while female gender was inversely associated (P = 0.0002). Peripheral arterial disease patients had higher absolute rates of both cardiovascular (CV) and all-cause death (both P < 0.0001). On Kaplan-Meier analysis, risk of all-cause death was higher in PAD patients compared with those without PAD (P < 0.0001), but PAD did not emerge as an independent risk factor for mortality on Cox regression analysis. A lower risk of all-cause death was associated with the prescription of statins (P = 0.0019), angiotensin-converting enzyme inhibitors (P = 0.0008), and calcium-channel blockers (P = 0.0071). CONCLUSION: Peripheral arterial disease is prevalent in 11% of AF patients and related to various atherosclerotic risk factors. Even if PAD is associated with higher risk of all-cause death on univariate analysis, this risk was significantly lowered and was no longer evident after adjusting for the use of CV prevention drugs.
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Physical activity contributes to a decrease in all-cause cardiovascular mortality and ischemic stroke, as shown in the EORP-AF study.
“Physical activity seems to contribute to a decrease in all-cause cardiovascular mortality and ischemic stroke, as shown in the EORP-AF study [65].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [65]
The Methods and Discussion passages examine peripheral arterial disease and cardiovascular-prevention drugs, not physical activity. Searches for physical activity, exercise, and ischemic stroke found no passage linking activity to reduced mortality or stroke in this study. (LLM, conf=0.76)
Experimental — accuracy not yet measuredIn the EORP-AF study of 2442 patients with AF, the intensity of physical activity was inversely correlated with the CHA2DS2-VASc score, and the high-intensity exercise training group presented reduced mortality and progression rates to permanent AF compared to groups of mild intensity or no exercise.
“The intensity of physical activity was inversely correlated with the CHA2DS2-VASc score, indicating that a smaller percentage of patients in the high-intensity group required anticoagulation compared to those in the mild-intensity group, where the percentage of patients receiving anticoagulants was higher [65].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [65]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredEndurance athletes with AF are shown to present more adverse symptoms than sedentary patients without exercise.
“Endurance athletes with AF are shown to present more adverse symptoms than sedentary patients without exercise [65].”
From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [65]
The Methods and Discussion (page numbers unavailable) compare patients with atrial fibrillation who have peripheral arterial disease with those who do not, focusing on cardiovascular events and mortality. Searches for endurance athletes, sedentary patients, exercise, and symptom comparisons found no passage addressing the claimed comparison. (LLM, conf=0.75)
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Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature
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Atrial Fibrillation and Surgical Patients with Peripheral Arterial Disease
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Can men with atrial fibrillation really rest easy with a CHA2DS2-VASc score of 0?
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Advanced Imaging Integration for Catheter Ablation of Ventricular Tachycardia
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Oral anticoagulation patterns and prognosis in octogenarian patients with atrial fibrillation
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PAD and Risk Factors: Systematic Review with ☸SAIMSARA
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Self-citation
- Authors
- Proietti, M., Raparelli, V., Laroche, C., Dan, G.-A., Janion, M., Popescu, R., Sinagra, G., Vijgen, J., Boriani, G., Maggioni, A. P., Tavazzi, L., Lip, G. Y. H., & on behalf of the EORP-AF Gen Pilot Investigators
- Affiliations
- Birmingham City Hospital (GB)
- Sapienza University of Rome (IT)
- European Society of Cardiology (FR)
- Carol Davila University of Medicine and Pharmacy (RO)
- Jan Kochanowski University (PL)
- Ospedale di Cattinara (IT)
- Jessa Hospital (BE)
- University of Modena and Reggio Emilia (IT)
- Maria Cecilia Hospital (IT)
- Corresponding author
- Lip, Gregory Y.H.
- ORCID
- Venue
- EP Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-12-09
- Volume
- 19
- Issue
- 9
- Pages
- 1439-1448
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2563878850
- Cited by
- 58
- References
- 42
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 11 · 2019: 6 · 2018: 6 · 2017: 2 · 2016: 1
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Funders
- Amgen (2012–2015)
- AstraZeneca (2014–2017)
- Bayer (2013–2018)
- Boehringer Ingelheim (2013–2016)
- Boston Scientific (2010–2012)
- Sanofi (2010–201)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, peripheral arterial disease, all-cause mortality, cardiovascular risk factors, statins, ACE inhibitors, calcium channel blockers, antiplatelet therapy, atherosclerosis
- MeSH terms
- Aged, Aged, 80 and over, Atrial Fibrillation, Cardiovascular Agents, Cause of Death, Europe, Female, Humans, Male, Middle Aged, Pilot Projects, Prognosis, Prospective Studies, Registries, Risk Factors, Time Factors, Prevalence, Multivariate Analysis, Chi-Square Distribution, Logistic Models, Proportional Hazards Models, Odds Ratio, Risk Assessment, Kaplan-Meier Estimate, Peripheral Arterial Disease
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