Registry of atrial fibrillation in Latin America: Primary results of the LACROSS study.
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de Barros E Silva Pedro Gabriel Melo, Damiani Lucas, Arantes Paola Engelmann, Ianof Jéssica Natuline, Yoshida Liandra Ayumi Federizi, Barbosa Lilian Mazza, Gomez-Mesa Juan Esteban, Bahit Maria Cecilia, Padilla Francisco Gerardo, Dall'Orto Frederico Toledo Campo, de Los Ríos Ibarra Manuel Odín, Antunes Murillo, Sánchez Alejandro Olaya, Cartasegna Luis, Tramujas Lucas, Dos Reis Saraiva Falcão Sandra Nivea, Hominal Miguel, Gamba Marco Antonio Alcocer, de Lima Carlos Eduardo Batista, Venancio Ana Claudia, Montenegro Eleonora, Muntaner Juan Antonio, Almagro Sandra Marcela, Troiani do Nascimento Charlene, Carneiro Ricardo Mendes, Montaña Oscar Romano, Lopes Renato D
Аннотация
METHODS: LACROSS was a multicenter, prospective cohort that included and followed for 1-year patients with AF at 40 sites across Argentina, Brazil, Colombia and Mexico from August 2020 to June 2024. Patient characteristics, concomitant medication use, and clinical outcomes are presented.
RESULTS: Of 2,012 patients enrolled, the median [quartiles] age was 72 [64 - 79] years, 41.1% were women, and 41.7% had permanent AF. Only 6.6% of patients had history of previous AF ablation and 14.2% had a previous cardioversion. The median CHA2DS2-VA score was 3 [2 - 4]; median HAS-BLED score was 2 [1 - 3]. At baseline, 29.7% were not on oral anticoagulants and, of those taking anticoagulants, 9.8% were taking vitamin K antagonists and 60.7% were taking direct oral anticoagulants. The primary reason for not using an oral anticoagulant was physician judgement due to low risk of thromboembolism (26.1%). The rates/100 [95%CI] patient-years of death, stroke, hospitalization due to AF, AF ablation, cardioversion, systemic embolism, and major bleeding were 9.58 [8.20 - 11.19], 1.09 [0.69 - 1.73], 20.18 [18.13 - 22.46], 1.99 [1.41 - 2.80], 2.23 [1.62 - 3.08], 0.30 [0.13 - 0.72], and 1.09 [0.69 - 1.73]. Older age, diabetes, and renal disease were independently associated with an increased risk of mortality or stroke, while higher body mass index, dyslipidemia, and DOAC use at baseline were associated with a lower risk of death.
CONCLUSIONS: LACROSS represents a contemporary registry of patients with AF in Latin America. A high percentage of patients are still without prescription of oral anticoagulation and the identification of diverse gaps in this treatment should guide future interventions to improve the care of patients with AF in Latin America.
TRIAL REGISTRATION: Study Registration: ClinicalTrials.gov ID NCT04456842.