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Prognostic impact of vascular disease in patients with atrial fibrillation: The Loire Valley Atrial Fibrillation

Ameenathul M Fawzy1, Arnaud Bisson2, Gregory Y H Lip3

  • 1Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.

Current Problems in Cardiology
|February 16, 2026
PubMed

Insights

Patients with atrial fibrillation (AF) and vascular disease face increased risks of all-cause mortality, stroke, and major bleeding. Careful management of these conditions is crucial for better patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Epidemiology

Background:

  • Vascular disease, including peripheral artery disease, coronary artery disease, and aortic disease, is linked to higher risks of atrial fibrillation (AF) and ischemic stroke (IS) in AF patients.
  • Understanding the impact of vascular disease on AF prognosis is essential for clinical management.

Purpose of the Study:

  • To investigate the effect of co-existing vascular disease on the prognosis of patients diagnosed with atrial fibrillation (AF).

Main Methods:

  • A retrospective analysis included 8962 AF patients, categorized into groups with and without vascular disease.
  • Outcomes assessed included a composite of death, stroke, thromboembolic events, all-cause mortality (ACM), stroke or systemic embolism (SSE), IS, hemorrhagic stroke, and major bleeding.

Main Results:

  • Patients with vascular disease showed a higher univariate risk for ACM, SSE, IS, and major bleeding compared to those without.
  • Multivariate analysis, after adjusting for CHA2DS2-VASc score and antithrombotic use, confirmed significantly increased risks of ACM, SSE, and major bleeding in AF patients with vascular disease.
  • The increased risk for IS was no longer significant in multivariate analysis, and a non-significant lower risk for hemorrhagic stroke was observed in patients with vascular disease.

Conclusions:

  • Atrial fibrillation patients with vascular disease face elevated risks of all-cause mortality, stroke or systemic embolism, and major bleeding.
  • This patient group requires comprehensive management strategies focusing on risk factor control and tailored treatment.
  • Further research is needed to fully elucidate the relationship between vascular disease and AF prognosis.
Abstract

Keywords:
Atrial fibrillationVascular disease

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