Background: Atrial fibrillation (AF) is a significant risk factor for cardiovascular (CV) mortality. This study aims to evaluate the prognostic implication of AF in patients with peripheral arterial disease (PAD). Methods: The International Reduction of Atherothrombosis for Continued Health (REACH) Registry included 23,542 outpatients in Europe with established coronary artery disease, cerebrovascular disease (CVD), PAD and/or ≥3 risk factors. Of these, 3753 patients had symptomatic PAD. CV risk factors were determined at baseline. Study end point was a combination of cardiac death, non-fatal myocardial infarction (MI) and stroke (CV events) during 2 years of follow-up. Cox regression analysis adjusted for age, gender and other risk factors (i.e., congestive heart failure, coronary artery re-vascularisation, coronary artery bypass grafting (CABG), MI, hypertension, stroke, current smoking and diabetes) was used. Results: Of 3753 PAD patients, 392 (10%) were known to have AF. Patients with AF were older and had a higher prevalence of CVD, diabetes and hypertension. Long-term CV mortality occurred in 5.6% of patients with AF and in 1.6% of those without AF (p<0.001). Multivariable analyses showed that AF was an independent predictor of late CV events (hazard ratio (HR): 1.5; 95% confidence interval (CI): 1.09-2.0). Conclusion: AF is common in European patients with symptomatic PAD and is independently associated with a worse 2-year CV outcome.

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Keywords Atrial fibrillation, Europe, Prognosis, REACH Registry, aged, article, cardiovascular agent, cardiovascular disease, chi square distribution, clinical trial, female, heart atrium fibrillation, heart infarction, human, male, middle aged, mortality, multicenter study, outpatient, peripheral vascular disease, prevalence, prognosis, proportional hazards model, prospective study, register, risk assessment; risk factor, stroke, time
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Journal European Journal of Vascular and Endovascular Surgery
Winkel, T.A, Hoeks, S.E, Schouten, O, Zeymer, U, Limbourg, T, Baumgartner, I, … Poldermans, D. (2010). Prognosis of Atrial Fibrillation in Patients with Symptomatic Peripheral Arterial Disease: Data from the REduction of Atherothrombosis for Continued Health (REACH) Registry. European Journal of Vascular and Endovascular Surgery, 40(1), 9–16. doi:10.1016/j.ejvs.2010.03.003