Key result
Upper and lower extremity arterial thromboembolism in nonvalvular AF share similar incidence and baseline characteristics.
Why the study?
Patients with chronic nonvalvular AF face a lifelong risk of thromboembolic events, motivating a comparison of baseline characteristics between patients presenting with upper versus lower extremity arterial thromboembolism secondary to nonvalvular AF.
Are there differences in baseline characteristics between patients presenting with upper versus lower extremity arterial thromboembolism as the first sign of nonvalvular atrial fibrillation?
Observational
Are there differences in baseline characteristics between patients presenting with upper versus lower extremity arterial thromboembolism as the first sign of nonvalvular atrial fibrillation?
Absolute Event Rate: 46.9% vs 53.1%
Acute arterial thromboembolism in either the upper or lower extremities can be the first presentation of nonvalvular atrial fibrillation, with no significant differences in patient baseline characteristics based on the location of the embolism.
Nearly equal upper/lower extremity involvement in AF thromboembolism with similar baselines; hypothesis-generating and should not change practice.
OBJECTIVES: Since nonvalvular atrial fibrillation is persistent in nature, patients with chronic nonvalvular atrial fibrillation are at life-time risk for development of thromboembolic events. Several novel oral anticoagulants have entered the market and there has been a growing body of evidence regarding their efficacy in prevention of ischemic stroke and arterial thromboembolism. The present study sought to compare the baseline characteristics between patients presenting with upper and lower extremity arterial thromboembolism developed secondary to nonvalvular atrial fibrillation. METHODS: This retrospective study was made up of patients presenting with acute upper or lower extremity arterial thromboembolism as the first presentation of atrial fibrillation. Patients were included if they had acute upper or lower critical limb ischemia symptoms lasting for less than one week. Patients in whom chronic peripheral artery disease was diagnosed were also excluded to prevent potential confounding. RESULTS: Overall, 46.9% of patients presented with upper extremity arterial thromboembolism and 53.1% of patients presented with lower extremity arterial thromboembolism. None of the baseline characteristics showed significant difference between patients with upper and lower extremity arterial thrombosis. CONCLUSION: It was observed that there was no significant difference in the incidence of extremity involvement of acute arterial thromboembolism occurring in patients with nonvalvular atrial fibrillation in our study, and we think that acute arterial thromboembolism must be taken into consideration as one of the first signs and symptoms of atrial fibrillation.
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Kızıltan et al. (2020) conducted an observational in Nonvalvular atrial fibrillation. Upper extremity arterial thromboembolism vs. Lower extremity arterial thromboembolism was evaluated on Incidence of extremity involvement. In patients with nonvalvular atrial fibrillation presenting with acute arterial thromboembolism, 46.9% had upper extremity and 53.1% had lower extremity involvement, with similar baseline characteristics.
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