{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:20:28Z","timestamp":1791908428961,"version":"4.3.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,11,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Atrial fibrillation is associated with increased mortality, but the specific causes of death and their predictors have not been described among patients on effective anticoagulant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      The Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) trial randomized 18\u2009113 patients (age, 71.5\u00b19 years; male, 64%; CHADS\n                      <jats:sub>2<\/jats:sub>\n                      score, 2.1\u00b11) to receive dabigatran or warfarin. Median follow-up was 2 years, and complete follow-up was achieved in 99.9% of patients. All deaths were categorized by the investigators using prespecified definitions followed by central adjudication. Overall, 1371 deaths occurred (annual mortality rate, 3.84%; 95% confidence interval [CI], 3.64\u20134.05). Cardiac deaths (sudden cardiac death and progressive heart failure) accounted for 37.4% of all deaths, whereas stroke- and hemorrhage-related deaths represented 9.8% of the total mortality. An examination of the causes of death according to dabigatran or warfarin showed that dabigatran significantly reduced vascular (embolism and hemorrhage-related) mortality (relative risk, 0.63; 95% CI, 0.45\u20130.88;\n                      <jats:italic>P<\/jats:italic>\n                      =0.007), whereas other causes of death were similar between treatments, including cardiac mortality (relative risk, 0.96; 95% CI, 0.80\u20131.15;\n                      <jats:italic>P<\/jats:italic>\n                      =0.638). The two strongest independent predictors of cardiac death in this population were heart failure (hazard ratio, 3.02; 95% CI, 2.45\u20133.73;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001), and prior myocardial infarction (hazard ratio, 2.05; 95% CI, 1.61\u20132.62;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>The majority of deaths are not related to stroke in a contemporary anticoagulated atrial fibrillation population. These results emphasize the need to identify interventions beyond effective anticoagulation to further reduce mortality in atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT00262600.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.112.000491","type":"journal-article","created":{"date-parts":[[2013,9,9]],"date-time":"2013-09-09T21:54:45Z","timestamp":1378763685000},"page":"2192-2201","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":284,"title":["Causes of Death and Influencing Factors in Patients With Atrial Fibrillation"],"prefix":"10.1161","volume":"128","author":[{"given":"Eloi","family":"Marijon","sequence":"first","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Yves","family":"Le Heuzey","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Connolly","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Yang","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Pogue","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Brueckmann","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Eikelboom","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of 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Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of the..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Wallentin","sequence":"additional","affiliation":[{"name":"From the Paris Cardiovascular Research Center, Paris, France (E.M.); Paris Descartes University, Paris, France (E.M., J.-Y.L.H.); European Georges Pompidou Hospital, Paris, France (E.M., J.-Y.L.H.); Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, ON, Canada (S.C., S.Y., J.P., J.E., E.T., S.Y.); Boehringer Ingelheim Pharma GmbH &amp; Co KG, Clinical Development and Medical Affairs, Ingelheim am Rhein, Germany, and Medical Faculty Mannheim of 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