Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III
Abstract Background Polypharmacy (i.e., treatment with ≥ 5 drugs) is common in patients with atrial fibrillation (AF) and has been associated with suboptimal management and worse outcomes. Little is known about how prescribed drug patterns affect management and prognosis in patients with AF. Methods...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12916-025-03858-w |
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| author | Bernadette Corica Giulio Francesco Romiti Giuseppe Boriani Brian Olshansky Tze-Fan Chao Menno V. Huisman Marco Proietti Gregory Y. H. Lip on behalf of the GLORIA-AF Investigators |
| author_facet | Bernadette Corica Giulio Francesco Romiti Giuseppe Boriani Brian Olshansky Tze-Fan Chao Menno V. Huisman Marco Proietti Gregory Y. H. Lip on behalf of the GLORIA-AF Investigators |
| author_sort | Bernadette Corica |
| collection | DOAJ |
| description | Abstract Background Polypharmacy (i.e., treatment with ≥ 5 drugs) is common in patients with atrial fibrillation (AF) and has been associated with suboptimal management and worse outcomes. Little is known about how prescribed drug patterns affect management and prognosis in patients with AF. Methods Based on data from the prospective global GLORIA-AF Registry Phase III (recruiting patients with AF and CHA2DS2-VASc score ≥ 1), we performed a latent class analysis to identify treatment patterns based on 14 drug classes including cardiovascular (CV) and non-CV drugs. We analysed associations with oral anticoagulant (OAC) use and risk of a composite primary outcome (all-cause death and major adverse cardiovascular events (MACE)) and secondary outcomes. Results Among 21,245 patients (mean age 70.2 ± 10.3 years, 44.9% females), we identified 6 patterns: i) Low Medicated pattern (18.3%); ii) Hypertension pattern (21.1%); iii) Heart Failure pattern (20.0%); iv) CV Prevention pattern (21.0%); v) Mixed Morbidity pattern (4.5%); and vi) High Medicated pattern (15.0%). All groups had higher odds of OAC use vs the Low Medicated pattern, with highest prevalences in the Heart Failure pattern (OR [95%CI]: 2.17 [1.90–2.48]) and the High Medicated pattern (OR [95%CI]: 2.08 [1.77–2.44]). Over 3-year follow-up, Heart Failure, Mixed Morbidity and High Medicated patterns were associated with higher risk of the primary composite outcome (aHR [95%CI]: 1.32 [1.14–1.53]; 1.45 [1.17–1.80] and 1.35 [1.14–1.60], respectively). Similar results were observed for all-cause mortality. Conclusions In patients with AF, different treatment patterns can be identified. Each pattern was associated with unique OAC use and long-term clinical outcomes. |
| format | Article |
| id | doaj-art-0be975cc4d244403b8d10b9ce2c3c175 |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Medicine |
| spelling | doaj-art-0be975cc4d244403b8d10b9ce2c3c1752025-01-26T12:37:19ZengBMCBMC Medicine1741-70152025-01-0123111010.1186/s12916-025-03858-wPatterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase IIIBernadette Corica0Giulio Francesco Romiti1Giuseppe Boriani2Brian Olshansky3Tze-Fan Chao4Menno V. Huisman5Marco Proietti6Gregory Y. H. Lip7on behalf of the GLORIA-AF InvestigatorsLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalCardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico Di ModenaDivision of Cardiology, Department of Medicine, University of Iowa Hospitals and ClinicsDivision of Cardiology, Department of Medicine, Taipei Veterans General HospitalDepartment of Thrombosis and Hemostasis, Leiden University Medical CenterDepartment of Clinical Sciences and Community Health, University of MilanLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest HospitalAbstract Background Polypharmacy (i.e., treatment with ≥ 5 drugs) is common in patients with atrial fibrillation (AF) and has been associated with suboptimal management and worse outcomes. Little is known about how prescribed drug patterns affect management and prognosis in patients with AF. Methods Based on data from the prospective global GLORIA-AF Registry Phase III (recruiting patients with AF and CHA2DS2-VASc score ≥ 1), we performed a latent class analysis to identify treatment patterns based on 14 drug classes including cardiovascular (CV) and non-CV drugs. We analysed associations with oral anticoagulant (OAC) use and risk of a composite primary outcome (all-cause death and major adverse cardiovascular events (MACE)) and secondary outcomes. Results Among 21,245 patients (mean age 70.2 ± 10.3 years, 44.9% females), we identified 6 patterns: i) Low Medicated pattern (18.3%); ii) Hypertension pattern (21.1%); iii) Heart Failure pattern (20.0%); iv) CV Prevention pattern (21.0%); v) Mixed Morbidity pattern (4.5%); and vi) High Medicated pattern (15.0%). All groups had higher odds of OAC use vs the Low Medicated pattern, with highest prevalences in the Heart Failure pattern (OR [95%CI]: 2.17 [1.90–2.48]) and the High Medicated pattern (OR [95%CI]: 2.08 [1.77–2.44]). Over 3-year follow-up, Heart Failure, Mixed Morbidity and High Medicated patterns were associated with higher risk of the primary composite outcome (aHR [95%CI]: 1.32 [1.14–1.53]; 1.45 [1.17–1.80] and 1.35 [1.14–1.60], respectively). Similar results were observed for all-cause mortality. Conclusions In patients with AF, different treatment patterns can be identified. Each pattern was associated with unique OAC use and long-term clinical outcomes.https://doi.org/10.1186/s12916-025-03858-wAtrial FibrillationComorbiditiesMultimorbidityClinical ComplexityLatent Class Analysis |
| spellingShingle | Bernadette Corica Giulio Francesco Romiti Giuseppe Boriani Brian Olshansky Tze-Fan Chao Menno V. Huisman Marco Proietti Gregory Y. H. Lip on behalf of the GLORIA-AF Investigators Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III BMC Medicine Atrial Fibrillation Comorbidities Multimorbidity Clinical Complexity Latent Class Analysis |
| title | Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III |
| title_full | Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III |
| title_fullStr | Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III |
| title_full_unstemmed | Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III |
| title_short | Patterns of pharmacological treatment in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF Registry Phase III |
| title_sort | patterns of pharmacological treatment in patients with atrial fibrillation an analysis from the prospective gloria af registry phase iii |
| topic | Atrial Fibrillation Comorbidities Multimorbidity Clinical Complexity Latent Class Analysis |
| url | https://doi.org/10.1186/s12916-025-03858-w |
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