Abstract：
OBJECTIVE: Anticoagulation can prevent stroke and prolong lives in patients with atrial fibrillation (AF); However, anticoagulated patients with AF remain at risk of death. The aim of this study was to investigate the causes of death and factors associated with all-cause and cardiovascular death in the XANTUS population.
RESULTS: Causes of death occurring within a year after rivaroxaban initiation in patients in the XANTUS program studies were adjudicated by a central adjudication committee and classified following international guidance.Baseline characteristics associated with all-cause or cardiovascular death were identified. Of 11,040 patients, 187 (1.7%) died. Almost half of these deaths were due to cardiovascular causes other than bleeding (n = 82, 43.9%), particularly heart failure (n = 38, 20.3%) and sudden or unwitnessed death (n = 24, 12.8%). Fatal stroke (n = 8, 4.3%), which was classified as a type of cardiovascular death, and fatal bleeding (n = 17, 9.1%) were less common causes of death. Independent factors associated with all-cause or cardiovascular death included age, AF type, body mass index, left ventricular ejection fraction, hospitalization at baseline, rivaroxaban dose, and anaemia.
CONCLUSIONS: The overall risk of death due to stroke or bleeding was low in XANTUS. Anticoagulated patients with AF remain at risk of death due to heart failure and sudden death. Potential interventions to reduce cardiovascular deaths in anticoagulated patients with AF, require further investigation, e.g. early rhythm control therapy and AF ablation.
RESULTS: Causes of death occurring within a year after rivaroxaban initiation in patients in the XANTUS program studies were adjudicated by a central adjudication committee and classified following international guidance.Baseline characteristics associated with all-cause or cardiovascular death were identified. Of 11,040 patients, 187 (1.7%) died. Almost half of these deaths were due to cardiovascular causes other than bleeding (n = 82, 43.9%), particularly heart failure (n = 38, 20.3%) and sudden or unwitnessed death (n = 24, 12.8%). Fatal stroke (n = 8, 4.3%), which was classified as a type of cardiovascular death, and fatal bleeding (n = 17, 9.1%) were less common causes of death. Independent factors associated with all-cause or cardiovascular death included age, AF type, body mass index, left ventricular ejection fraction, hospitalization at baseline, rivaroxaban dose, and anaemia.
CONCLUSIONS: The overall risk of death due to stroke or bleeding was low in XANTUS. Anticoagulated patients with AF remain at risk of death due to heart failure and sudden death. Potential interventions to reduce cardiovascular deaths in anticoagulated patients with AF, require further investigation, e.g. early rhythm control therapy and AF ablation.
摘要：
目的：抗凝治疗可以预防房颤(AF)患者的卒中，延长患者的生命；抗凝房颤患者仍有死亡风险.这项研究的目的是调查XANTUS人群的死亡原因以及与全因和心血管死亡相关的因素。
结果：XANTUS项目研究中患者开始使用利伐沙班后一年内死亡的原因由中央裁决委员会裁决，并根据国际指导进行分类。确定了与全因死亡或心血管死亡相关的基线特征。在11,040名患者中，187人（1.7%）死亡。这些死亡中几乎一半是由于出血以外的心血管原因（n=82，43.9%）。尤其是心力衰竭（n=38，20.3％）和猝死或目击死亡（n=24，12.8％）。致命中风（n=8，4.3％），这被归类为一种心血管死亡，致死性出血(n=17,9.1%)是较不常见的死亡原因。与全因死亡或心血管死亡相关的独立因素包括年龄，AF类型,身体质量指数,左心室射血分数,基线时住院，利伐沙班剂量,和贫血.
结论：XANTUS患者卒中或出血导致的总体死亡风险较低。房颤抗凝患者仍有因心力衰竭和猝死而死亡的风险。降低房颤抗凝患者心血管死亡的潜在干预措施,需要进一步调查,如早期节律控制治疗和房颤消融术。
结果：XANTUS项目研究中患者开始使用利伐沙班后一年内死亡的原因由中央裁决委员会裁决，并根据国际指导进行分类。确定了与全因死亡或心血管死亡相关的基线特征。在11,040名患者中，187人（1.7%）死亡。这些死亡中几乎一半是由于出血以外的心血管原因（n=82，43.9%）。尤其是心力衰竭（n=38，20.3％）和猝死或目击死亡（n=24，12.8％）。致命中风（n=8，4.3％），这被归类为一种心血管死亡，致死性出血(n=17,9.1%)是较不常见的死亡原因。与全因死亡或心血管死亡相关的独立因素包括年龄，AF类型,身体质量指数,左心室射血分数,基线时住院，利伐沙班剂量,和贫血.
结论：XANTUS患者卒中或出血导致的总体死亡风险较低。房颤抗凝患者仍有因心力衰竭和猝死而死亡的风险。降低房颤抗凝患者心血管死亡的潜在干预措施,需要进一步调查,如早期节律控制治疗和房颤消融术。
