{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:44:02Z","timestamp":1753868642762,"version":"3.41.2"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with atrial fibrillation (AF) and heart failure (HF) have a high risk of thromboembolism and other outcomes and anticoagulation is recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>This study was aimed to explore the risk factors associated with HF worsening in patients with AF and HF taking rivaroxaban in Spain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicenter, prospective, observational study that included adults with AF and chronic HF, receiving rivaroxaban \u22654 months before entering. HF worsening was defined as first hospitalization or emergency visit because of HF exacerbation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 672 patients from 71 Spanish centers were recruited, of whom 658 (97.9%) were included in the safety analysis and 552 (82.1%) in the per protocol analysis. At baseline, mean age was 73.7\u2009\u00b1\u200910.9 years, 64.9% were male, CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc was 4.1\u2009\u00b1\u20091.5, HAS\u2010BLED was 1.6\u2009\u00b1\u20090.9% and 51.3% had HF with preserved ejection fraction. After 24 months of follow\u2010up, 24.9% of patients developed HF worsening, 11.6% died, 2.9% had a thromboembolic event, 3.1% a major bleeding, 0.5% an intracranial bleeding and no patient had a fatal hemorrhage. Older age, the history of chronic obstructive pulmonary disease, the previous use of vitamin K antagonists, and restrictive or infiltrative cardiomyopathies, were independently associated with HF worsening. Only 6.9% of patients permanently discontinued rivaroxaban treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately one out of four patients with HF and AF treated with rivaroxaban developed a HF worsening episode after 2 years of follow\u2010up. The identification of those factors that increase the risk of HF worsening could be helpful in the comprehensive management of this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24189","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:59:16Z","timestamp":1701262756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with disease progression in patients with atrial fibrillation and heart failure anticoagulated with rivaroxaban"],"prefix":"10.1002","volume":"47","author":[{"given":"Nicol\u00e1s","family":"Manito","sequence":"first","affiliation":[{"name":"Cardiology Department Hospital Universitario de Bellvitge Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Cepeda\u2010Rodrigo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hospital Vega Baja Orihuela 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