Reasons for hospitalization and risk of mortality in patients with atrial fibrillation treated with dabigatran or warfarin in the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
AimsHospitalizations are common among patients with atrial fibrillation. This article aimed to analyse the causes and consequences of hospitalizations occurring during the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial.Methods and resultsThe RE-LY database was used to evaluate predictors of hospitalization using multivariate regression modelling. The relationship between hospitalization and subsequent major adverse cardiac events was evaluated in a time dependent Cox proportional-hazard modelling. Of the 18 113 patients in RE-LY, 7200 (39.8%) were hospitalized at least once during a mean follow-up of 2 years. First hospitalization rates were 2312 (39.5%) for dabigatran etexilate (DE) 110, 2430 (41.6%) for DE 150, and 42.6% (N = 2458) for warfarin. Hospitalization was associated with post-discharge death [absolute event rate 9.1% vs. 2.2%; adjusted hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.2–4.0, P < 0.0001], vascular death (adjusted HR 2.9, 95% CI 2.5–3.3, P < 0.0001), and sudden cardiac death (adjusted HR 2.3; 95% CI 1.8–2.9, P < 0.0001). Cardiovascular hospitalization was also associated with an increased risk of post-discharge death (adjusted HR 2.8, 95% CI 2.5–3.2, P < 0.0001), vascular death (adjusted HR 2.8, 95% CI 2.4–3.2, P < 0.0001), and sudden cardiac death (adjusted HR 2.1, 95% CI 1.6–2.7, P < 0.0001) compared with patients not hospitalized for any cardiovascular reason.ConclusionHospitalizations are associated an increased risk of with death and cardiovascular death in patients with atrial fibrillation.
