Falls a red flag for poor outcomes in atrial fibrillation

Fall episodes in individuals with atrial fibrillation (AF) may signal poor outcomes, including intracranial haemorrhage and mortality, according to a study.

For the study, researchers conducted a post hoc analysis of the RE-LY trial to determine intracranial haemorrhage and major bleeding outcomes. The analysis included 18,113 individuals with AF, with the outcomes compared according to the status occurrence of falls (or head injury) reported as adverse events.

A total of 974 fall episodes or head injury events were documented among 716 patients (4 percent). Participants who had a fall vs had no fall episode tended to be older and had more frequently comorbidities such as diabetes, previous stroke, or coronary artery disease.

Multivariate Cox regression models showed that fall was associated with a higher risk of major bleeding (HR, 2.41, 95 percent CI, 1.90–3.05), intracranial haemorrhage (HR, 1.69, 95 percent CI, 1.35–2.13), and mortality (HR, 3.91, 95 percent CI, 2.51–6.10).

Furthermore, among participants who had falls, those who received dabigatran had a lower risk of intracranial haemorrhage compared with those who received warfarin.