Real world data in AF patient registry highlights increased stroke risk among diabetes patients in AF

Data from new sub-analyses of the PREvention oF thromboembolic events—European Registry in Atrial Fibrillation (PREFER in AF) patient registry which reveals at-risk patient groups, current treatment gaps in the management of atrial fibrillation (AF) and trends associated with specific patient characteristics were presented at the European Society of Cardiology conference held in Rome, Italy.

The registry, sponsored by Daiichi Sankyo, informs on AF patient profiles in a real-world clinical context, helping to identify specific at-risk patient groups, including those with comorbidities that predispose them to thrombotic events. Data from the registry reveals that AF patients with diabetes, on insulin treatment are at a significantly increased risk of stroke/systemic embolism at one year follow-up compared to AF patients without diabetes (5.2% versus 1.9% respectively; Hazard Ratio [HR] 2.89, 95% Confidence Interval [CI] 1.67-5.02; P=0.0002) and compared to those with diabetes not on insulin treatment (5.2% versus 1.8% respectively; HR 2.96, 1.49-5.87; P=0.0019).It also found that diabetic patients not receiving insulin therapy had similar incidence of thromboembolic events than patients without diabetes (HR 0.97, 0.58-1.61; P=0.9). 

Through comprehensive data capture, the registry has also enabled a comparison of specific patient characteristics such as gender alongside clinical aspects including therapy choice and clinical outcomes. The registry has revealed that women experience a greater burden of symptoms compared to men and that treatment with oral anticoagulation is similar in both genders. Compared to men, women were found to be at 65% lower age and country-adjusted risk of coronary revascularisation at one year (95% CI [0.22, 0.56]), 40% lower risk of acute coronary syndrome (0.38 to 0.93) and 20% lower risk of chronic heart insufficiency/reduced left ventricular ejection fraction (0.68, 0.96). 

“These results are greatly beneficial to physicians in clinical practice,” commented Dr. Giuseppe Patti, Campus Bio-Medico University, Rome, Italy and lead author of the study. “The burden of AF is a considerable healthcare issue which carries a heightened risk of stroke for over six million sufferers in Europe. The availability of robust, real-world data to inform on patients at even greater risk of stroke or systemic embolism, will help identify where specific care is needed to minimise these outcomes.” 

There was no evidence that men and women differed in stroke, transient ischaemic attack, arterial thromboembolic events and major bleeding events over one year. While the results provide an indication of gender differences, further research is needed to establish whether this can be used to enhance AF management, determining prevention and treatment needs. 

“AF represents a significant concern across Europe, and we are pleased that the PREFER in AF registry sheds light on the current management of AF in a clinical setting, through delivery of this additional sub-study data,” stated Dr. Juan-Carlos Jaramillo, Senior Vice President, Head of Market Access & Medical Affairs, Daiichi Sankyo Europe GmbH. “By adding to the data available in this important disease area, Daiichi Sankyo is committed to supporting advancement in cardiovascular medicine and improvements in patient care.”