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Atrial fibrillation and vascular disease-a bad combination

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  1. The prognostic significance of lung function in stable heart failure outpatients

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  2. Cardioversion of Atrial Fibrillation in ENGAGE AF-TIMI 48

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  1. Polygenic predisposition to breast cancer and the risk of coronary artery disease

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  2. Cardiovascular Manifestations of Systemic Sclerosis: A Danish Nationwide Cohort Study

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  3. Rate and rhythm therapy in patients with atrial fibrillation and the risk of pacing and bradyarrhythmia

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  4. Utility of left atrial strain for predicting atrial fibrillation following ischemic stroke

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This article provides an overview of (i) the risk of stroke associated with vascular disease (acute coronary syndromes and peripheral artery disease) in patients with atrial fibrillation, (ii) the frequent coexistence of vascular disease in patients with atrial fibrillation and, (iii) the cardiovascular risk associated with the coexisting of the two diseases. The literature on this topic is relatively sparse, and we discuss results from both clinical trials and observational studies. There is a clear indication of an increased stroke risk associated with vascular disease in patients with atrial fibrillation. Indeed, patients with atrial fibrillation often had coexisting vascular disease (around 18%), and the combination of the two diseases substantially increases the risk of future cardiovascular events. The increased risk associated with peripheral artery disease in atrial fibrillation is even more pronounced. Patients with atrial fibrillation and stable vascular disease should be treated with oral anticoagulation only, although when these patients present with acute coronary syndrome and/or undergo coronary stenting, concomitant treatment with antiplatelet drugs is indicated. To guide antithrombotic management in patients with atrial fibrillation, several stroke and bleeding risk prediction schemes have been developed. Clin. Cardiol. 2012 DOI: 10.1002/clc.20955 Dr. Olesen received an honorarium through an educational grant from Sanofi Aventis for time and expertise spent writing this article. Dr Lip has served as a consultant for Bayer, Astellas, Merck, AstraZeneca, Sanofi, BMS/Pfizer, Biotronik, Portola and Boehringer Ingelheim and has been on the speakers bureau for Bayer, BMS/Pfizer, Boehringer Ingelheim, and Sanofi-Aventis. Drs. Gislason and Torp-Pedersen disclose no conflicts of interest.
Original languageEnglish
JournalClinical Cardiology (Hoboken)
Volume35 Suppl 1
Pages (from-to)S15-20
ISSN0160-9289
DOIs
Publication statusPublished - 2012

ID: 33214548