Cardiovascular-Kidney-Metabolic Interplay in Patients with Atrial Fibrillation Receiving Direct Oral Anticoagulants - PubMed
a day ago
- #CKM syndrome
- #DOACs
- #atrial fibrillation
- The study examines the impact of Cardiovascular-Kidney-Metabolic (CKM) syndrome on outcomes in atrial fibrillation (AF) patients treated with direct oral anticoagulants (DOACs).
- A multicenter Taiwanese database of 17,378 AF patients (mean age 76.1 years; 40.9% women) was analyzed from 2012 to 2021.
- Patients were categorized by the number of CKM domains (0 to 3), with 18.2%, 35.0%, 32.2%, and 14.6% having 0, 1, 2, and 3 domains, respectively.
- Women more frequently exhibited kidney, metabolic, or combined CKM domains.
- Clinical risks increased stepwise with the number of CKM domains; those with 3 domains had the highest risks of adverse events, including ischemic stroke, major bleeding, heart failure hospitalization, and mortality.
- Kidney involvement conferred the strongest risks for most outcomes, while cardiovascular and metabolic domains were more associated with ischemic stroke/systemic embolic events/acute coronary syndrome.
- Years of life lost (YLL) increased with more CKM domains, with greater reductions observed in females, particularly in cardiovascular and metabolic domains.
- The study concludes that a higher CKM burden correlates with worse prognosis and shorter life expectancy in AF patients on DOACs, with more pronounced effects in women.