1. Epidemiology of Atrial Fibrillation in Europe:
A Comparison of the EURObservational Research Programme Atrial Fibrillation Pilot Registry and
Euro Heart Survey on Atrial Fibrillation
Marco Proietti, Paul-Edouard Bouvet, Cécile Laroche, Robby Nieuwlaat, Harry J.G.M. Crijns, Aldo P. Maggioni, Deirdre A. Lane, Giuseppe Boriani, Gregory Y.H. Lip. on behalf of EORP-AF General Pilot Registry and Euro Heart Survey on AF Investigators

2. - Consu lting/Royalties/Owner/ Stockholder of a healthcare company (Small consulting fee from Boehringer lngelheim)

3. Background
Atrial Fibrillation (AF) epidemiology shows significant temporal trends
These changes affect both prevalence, incidence as well as major adverse events
Benjamin Circulation 2017;135:e146
Chugh Circulation 2014;129:837

4. Background
In 2005, the European Society of Cardiology (ESC) conducted the Euro Heart Survey (EHS) on AF to assess current practice on AF and adherence to clinical guidelines
In 2015, ESC concluded the 1 year follow-up of the EURObservational Research Programme AF (EORP-AF) Pilot Registry, aimed to investigate similar aims after ten years from the original EHS study
Nieuwlaat EHJ 2005;26:2422
Lip Europace 2014;16:308

5. Aims
We hypothesised differences in clinical and risk profiles, therapeutic approaches and outcomes between AF patients enrolled in EORP-AF and EHS.
Methods
A propensity score matching (PSM) based on age, gender, type of AF, BMI, sitting blood pressure and basic cardiovascular risk factors was built to match the two cohorts.
Baseline characteristics and outcomes were compared following PSM pooled analysis between patients enrolled in the EORP-AF and EHS cohorts.

6. Results
After propensity score matching 5206 patients (mean age 68.4 years, 59.1% males) were retrieved for analysis
Differences in Baseline Characteristics
*All comparisons presented are statistically significant different

7. Results
EORP-AF patients had more prevalent oral anticoagulant (OAC) use (80.4% vs. 64.9%, p<0.001), with no differences in antiplatelet drugs use
Differences in Distribution for Antithrombotic Patters in High Thromboembolic Risk Patients

8. Results Logistic Analysis for Outcomes at 1-year Follow-Up
EORP-AF Pilot vs. EHS
Model 1*
Model 2† OR
95% CI p
Stroke/TIA
0.18
<0.001
Stroke/TIA/PE
0.21
CAD/MI
0.55
0.001
0.56
0.004
Any Bleeding
0.72
0.400
0.63
0.300
CV Death
2.32
0.019
2.54
0.015
CV Death - Stroke/TIA - Any Bleeding
0.83
0.322
0.84
0.388
CV Death - CAD/MI
0.87
0.352
0.88
0.431
All-Cause Death
1.25
0.256
1.23
0.321
Readmission for AF
0.34
0.29
Readmission for Other CV Reasons
0.44
*Adjusted for age, gender, type of AF, CHA2DS2-VASc; †Adjusted for all previous covariates plus use of any OAC

9. Results
Kaplan-Meier Curves for Cardiovascular and All-Cause Death at 1-year Follow-Up

10. Multivariate Analysis
Results
Cox Regression Analysis for Cardiovascular and All-Cause Death at 1-year Follow-Up
Multivariate Analysis HR
95% CI p
Cardiovascular Death
All-Cause Death
Age (per year)
1.04
<0.001
1.06
Type of AF
First Detected -
Paroxysmal
0.35
0.53
0.007
0.55
0.59
0.002
0.003
Persistent
0.62
0.037
0.81
0.221
Permanent
Diabetes Mellitus
1.84
0.001
1.61
Vascular Disease
2.32
1.79
Chronic Heart Failure
4.11
2.49
EORP-AF Pilot (vs. EHS)
1.62
0.021

11. Conclusions
Significant temporal changes are found in AF epidemiology, with contemporary patients being older and more burdened with comorbidities.
Changes are evident in patients’ management, with a greater use of OAC.
Despite these changes leading to a reduction in risk in thromboembolic events, a residual excess risk of CV-related death is evident.