{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:33:51Z","timestamp":1772253231616,"version":"3.50.1"},"reference-count":38,"publisher":"Sociedade Brasileira de Cardiologia","issue":"2","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  Antagonistas da vitamina K (AVK) representam uma importante estrat\u00e9gia terap\u00eautica oferecida pelo Sistema \u00danico de Sa\u00fade no Brasil aos pacientes com fibrila\u00e7\u00e3o atrial (FA). Entretanto, os preditores de desfechos cl\u00ednicos relevantes s\u00e3o pouco estudados no mundo real.  Objetivo  Determinar a incid\u00eancia e os preditores independentes de desfechos cl\u00ednicos em pacientes com FA valvar e n\u00e3o valvar tratados com AVK.  M\u00e9todos  Coorte prospectivo de pacientes com FA valvar e n\u00e3o valvar em uso \u2265 1 ano de AVK. Desfechos prim\u00e1rios foram morte cardiovascular, eventos tromboemb\u00f3licos, sangramento maior e n\u00e3o maior clinicamente relevante, separadamente e como desfecho composto, e adjudicados de modo independente. Valores de p &lt; 0,05 foram considerados estatisticamente significantes.  Resultados  Inclu\u00eddos 1.350 pacientes, idade m\u00e9dia de 69,2 (\u00b1 11.8) anos e 53,6% do sexo feminino, seguidos por 17 (15 - 19) meses. Incid\u00eancia anual de eventos tromboemb\u00f3licos e morte cardiovascular foi 4,4% e preditores foram tromboembolismo pr\u00e9vio (hazard ratio [HR] 2,12; intervalo de confian\u00e7a [IC] de 95% 1,22 - 3,67), tempo na faixa terap\u00eautica (TFT) &lt; 50% (HR 1,98; IC95% 1,16 - 3,37), e taxa de filtra\u00e7\u00e3o glomerular (TFG) &lt; 45 mL\/min\/1.73 m2 (HR 2,76; IC95% 4,82 - 1,58). Taxa de sangramento maior e n\u00e3o maior clinicamente relevante foram 3,24% por ano (IC95% 2,47 - 4,14) e preditores foram sangramento pr\u00e9vio (HR 2,60; IC95% 1,47 - 4,61) e pr\u00f3tese mec\u00e2nica (HR 1,91; IC95% 1,15 - 3,15). O desfecho composto foi 8,7% por ano e preditores foram sangramento pr\u00e9vio (HR 1,70; IC95% 1,07 - 2,70), TFT &lt; 41% (HR 1,79; IC95% 1,11 - 2,86) e di\u00e2metro do \u00e1trio esquerdo &gt; 44 mm (HR 1,97; IC95% 3,26 - 1,19).  Conclus\u00f5es  Tromboembolismo ou sangramento pr\u00e9vios, TFG e TFT reduzidos e \u00e1trio esquerdo aumentado foram preditores de desfechos cl\u00ednicos em pacientes com FA tratados com AVK.<\/jats:p>","DOI":"10.36660\/abc.20240147","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T10:29:14Z","timestamp":1739442554000},"source":"Crossref","is-referenced-by-count":0,"title":["Incid\u00eancia e Preditores de Desfechos Cl\u00ednicos em Pacientes com Fibrila\u00e7\u00e3o Atrial Valvar e N\u00e3o Valvar em uso de Antagonistas da Vitamina K"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0746-6594","authenticated-orcid":false,"given":"Idelzuita Leandro","family":"Liporace","sequence":"first","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1815-6498","authenticated-orcid":false,"given":"Gustavo Bernardes F.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil; Hospital Alem\u00e3o Oswaldo Cruz,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas Bassolli de Oliveira","family":"Alves","sequence":"additional","affiliation":[{"name":"Hospital Alem\u00e3o Oswaldo Cruz,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia Marchiori","family":"Galassi","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreia Dias","family":"Jeronimo","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda Maria","family":"Lopes","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"University of Liverpool,  Reino Unido; Liverpool Heart & Chest Hospital,  Reino Unido; Aalborg Universitet,  Dinamarca"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lvaro","family":"Avezum","sequence":"additional","affiliation":[{"name":"Hospital Alem\u00e3o Oswaldo Cruz,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart Disease and Stroke Statistics-2018 Update: A Report from the American Heart Association","volume":"137","author":"Benjamin EJ","year":"2018","journal-title":"Circulation"},{"issue":"2","key":"ref2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1093\/ehjqcco\/qcaa093","article-title":"Atrial Fibrillation in the UK: Predicting Costs of an Emerging Epidemic Recognizing and Forecasting the Cost Drivers of Atrial Fibrillation-related Costs","volume":"8","author":"Burdett P","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"857","DOI":"10.7326\/0003-4819-146-12-200706190-00007","article-title":"Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients who Have Nonvalvular Atrial Fibrillation","volume":"146","author":"Hart RG","year":"2007","journal-title":"Ann Intern Med"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1161\/01.CIR.0000063575.17904.4E","article-title":"American Heart Association\/American College of Cardiology Foundation Guide to Warfarin Therapy","volume":"107","author":"Hirsh J","year":"2003","journal-title":"Circulation"},{"issue":"5","key":"ref5","first-page":"72","article-title":"2020 ACC\/AHA Guideline for the Management of Patients with Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto CM","year":"2021","journal-title":"Circulation"},{"issue":"4","key":"ref6","first-page":"720","article-title":"Update of the Brazilian Guidelines for Valvular Heart Disease - 2020","volume":"115","author":"Tarasoutchi F","year":"2020","journal-title":"Arq Bras Cardiol"},{"key":"ref7","series-title":"Apixabana, Rivaroxabana e Dabigratana em Pacientes com Fibrila\u00e7\u00e3o Atrial N\u00e3o Valvar. 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