{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:07:57Z","timestamp":1776769677166,"version":"3.51.2"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anaemia is a common comorbidity in patients with atrial fibrillation (AF) receiving oral anticoagulants (OACs). While its relationship with bleeding is well established, the prothrombotic role and ethnic variations remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed two large prospective AF registries from Europe (EORP\u2010AF) and East Asia (APHRS\u2010AF). Patients were classified by anaemia status at enrolment. Logistic regression assessed clinical correlates and treatment patterns, while multivariable Cox models and propensity score matching (PSM) evaluated outcomes. Restricted cubic spline analyses explored the haemoglobin\u2013risk relationship across ethnic groups. The primary outcome was a composite of all\u2010cause death and major adverse cardiovascular events (MACE); secondary outcomes included individual components and major bleeding (MB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 10,857 patients with AF (mean age 69\u2009\u00b1\u200911\u2009years, 40.0% women), 3372 (31.0%) had anaemia, which clustered with multimorbidity and frailty. Anaemic patients were less likely to receive OACs (OR 0.67, 95% CI 0.58\u20130.78) and rhythm\u2010control (OR 0.91, 95% CI 0.81\u20131.02). Anaemia was independently associated with higher risk of the composite outcome (HR 1.54, 95% CI 1.34\u20131.78), all\u2010cause death (HR 1.81, 95% CI 1.51\u20132.15), MACE (HR 1.39, 95% CI 1.16\u20131.66), CV death (HR 1.90, 95% CI 1.43\u20132.54) and MB (HR 1.79, 95% CI 1.31\u20132.46) consistent also after PSM. Risk increased progressively with anaemia severity, particularly below 10\u2009g\/dL. Associations were consistent across Asian and European cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anaemia identifies a vulnerable AF phenotype associated with excess mortality, adverse cardiovascular outcomes and increased bleeding risk, which remains frequently undertreated. Risk rises with anaemia severity, and although biological effects appear consistent across ethnicities, treatment disparities persist. Anaemia should refine, not restrict, therapy within integrated AF care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.70205","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T13:38:43Z","timestamp":1776519523000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Anaemia on Management and Outcomes in Patients With Atrial Fibrillation: Insights From European and Asian Cohorts"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7119-1254","authenticated-orcid":false,"given":"Andrea Galeazzo","family":"Rigutini","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Internal, Vascular and Emergency Medicine \u2013 Stroke Unit University of Perugia  Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Internal, Vascular and Emergency Medicine \u2013 Stroke Unit University of Perugia  Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2803-079X","authenticated-orcid":false,"given":"Amir","family":"Askarinejad","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences Italy University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Rossi","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Life, Health &amp; Environmental Sciences University of L'Aquila  L'Aquila Italy"},{"name":"Internal Medicine and Nephrology Division ASL1 Avezzano\u2010Sulmona\u2010L'Aquila, San Salvatore Hospital  L'Aquila Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Becattini","sequence":"additional","affiliation":[{"name":"Internal, Vascular and Emergency Medicine \u2013 Stroke Unit University of Perugia  Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences Italy University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4665-7887","authenticated-orcid":false,"given":"Hung\u2010Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"The University of Hong Kong, Hong Kong Special Administrative Region of China  Pok Fu Lam Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6587-3094","authenticated-orcid":false,"given":"Tze\u2010Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine and Cardiovascular Research Centre National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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