內科Goto, ShinyaShinyaGotoBhatt, Deepak L.Deepak L.BhattRother, JoachimJoachimRotherAlberts, MarkMarkAlbertsHill, Michael D.Michael D.HillIkeda, YasuoYasuoIkedaUchiyama, ShinichiroShinichiroUchiyamaD'Agostino, RalphRalphD'AgostinoOhman, E. MagnusE. MagnusOhmanLiau, Chiau-SuongChiau-SuongLiauHirsch, Alan T.Alan T.HirschMas, Jean-LouisJean-LouisMasWilson, Peter W.F.Peter W.F.WilsonCorbalan, RamonRamonCorbalanAichner, FranzFranzAichner2009-12-182018-07-112009-12-182018-07-112008http://ntur.lib.ntu.edu.tw//handle/246246/174617Background Atrial fibrillation (AF) is a major risk factor ( RF) for ischemic stroke. Its prevalence and prognostic impact in patients with atherothrombosis are unclear. Methods Risk factors, drug usage, and 1-year cardiovascular( CV) outcomes (CV death, myocardial infarction [MI], and stroke) were compared in AF and non-AF patients from the REduction of Atherothrombosis for Continued Health (REACH) Registry, an international, prospective cohort of 68,236 stable outpatients with established otherothrombosis or >= 3 atherothrombotic RFs. Result Atrial fibrillation and 1-year follow-up data are available for 63,589 patients. The prevalence of AF was, 12.5%, 13.7%, 11.5%, and 6.2% among coronary artery disease, CV disease, peripheral artery disease, and RF-only patients, respectively. Of the 6,814 patients with AF, 6.7% experienced CV death, nonfatal MI, or nonfatal stroke within a year. The annual incidence of nonfatal stroke (2.4% vs 1.6%, P < .0001) and unstable angina (6.0% vs 4.0 %, P < .00001) was higher, and CV death was more than double (3.2% vs 1.4% , P < .0001), in AF versus non-AF patients. In these patients with or at high risk of atherothrombosis, most patients with AF received antiplatelet agents, but only 53.1% were treated with oral anticoagulants. Even with high CHADS(2) (congestive heart failure, hypertension, aging, diabetes mellitus, and stroke) scores, anticoagulant use did not exceed (59%). The rate of bleeding requiring hospitalization was higher in AF versus non-AF patients (1.5% vs 0.8%, P < .0001), possibly related to the more frequent use of anticoagulants (53.1% vs 7.1%). Conclusions Atrial fibrillation is common in patients with atherothrombosis, associated with more frequent fatal and nonfatal CV outcomes, and underuse of oral anticoagulants.en-US[SDGs]SDG3acetylsalicylic acid; anticoagulant agent; antithrombocytic agent; aged; aging; artery disease; article; atherosclerosis; bleeding; cardiovascular risk; comparative study; congestive heart failure; controlled study; coronary artery disease; diabetes mellitus; drug use; female; follow up; heart atrium fibrillation; heart death; heart infarction; hospitalization; human; hypertension; major clinical study; male; outcome assessment; prevalence; priority journal; prognosis; prospective study; risk factor; stroke; thrombosis; unstable angina pectorisjournal article10.1016/j.ahj.2008.06.029