In Latin American AF patients, 22.9% were not anticoagulated, DOAC use was 60.7%, and older age, diabetes, renal disease raised death/stroke risk while DOACs lowered death risk.
The LACROSS registry highlights significant gaps in oral anticoagulation use among Latin American patients with atrial fibrillation, alongside high rates of mortality and AF-related hospitalizations.
Absolute Event Rate: 0% vs 0%
Abstract Background Atrial fibrillation (AF) affects more than 1% of the adult population but there is limited data of these patients in Latin America. We sought to evaluate the characteristics, treatment patterns, and clinical outcomes in patients with AF by conducting a registry in four countries in Latin America. 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 were assessed. Results A total of 2,012 patients were included, the median IQR age was 72 64 - 79 years, 41.1% were women, and 41.7% had permanent AF (Table 1). 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, 22.9% were not on oral anticoagulants and varying from 21.8% to 27.1% in patients with CHA2DS2-VA ≥ 2 or 2, respectively (Figure1). In the first assessment , 16.4% were taking vitamin K antagonists and 60.7% were taking direct oral anticoagulants. The primary reason for not using an oral anticoagulant (26.1%). was physician judgement due to low risk of thromboembolism 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. In a multivariable analysis, 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 large contemporary and prospective registry of patients with AF in Latin America. Our findings highlight important gaps in treatment, which can inform clinical practice and guide future interventions to improve the care of these patients.Table 1 Figure 1
Silva et al. (Sat,) reported a other. In Latin American AF patients, 22.9% were not anticoagulated, DOAC use was 60.7%, and older age, diabetes, renal disease raised death/stroke risk while DOACs lowered death risk.