TY - JOUR
T1 - Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation
T2 - a report from the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) Long-Term General Registry
AU - Boriani, Giuseppe
AU - Proietti, Marco
AU - Laroche, Cécile
AU - Fauchier, Laurent
AU - Marin, Francisco
AU - Nabauer, Michael
AU - Potpara, Tatjana
AU - Dan, Gheorghe-Andrei
AU - Kalarus, Zbigniew
AU - Diemberger, Igor
AU - Tavazzi, Luigi
AU - Maggioni, Aldo P
AU - Lip, Gregory Y H
AU - EORP-AF Long-Term General Registry Investigators
A2 - Joensen, Albert Marni
A2 - Gammelmark, Anders
A2 - Rasmussen, Lars Hvilsted
A2 - Dinesen, Pia Thisted
A2 - Riahi, Sam
A2 - Venø, Stine Krogh
A2 - Sørensen, Bodil Ginnerup
A2 - Korsgaard, Anne Marie
A2 - Andersen , Karen Petrea
A2 - Hellum, Camilla Fragtrup
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed.Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84.9%), with non-vitamin K antagonists (NOACs) accounting for 40.9% of OACs. Antiplatelet therapy alone was used by 20% of patients, while no antithrombotic treatment was prescribed in 6.4%. On multivariable analysis, age, hypertension, previous ischaemic stroke, symptomatic AF and planned cardioversion or ablation were independent predictors of OAC use, whereas lone AF, previous haemorrhagic events, chronic kidney disease and admission for acute coronary syndrome (ACS) or non-cardiovascular causes independently predicted OAC non-use. Regarding the OAC type, coronary artery disease, history of heart failure, or valvular heart disease, planned cardioversion and non-AF reasons for admission independently predicted the use of vitamin K antagonists (VKAs). Wide variability among the European regions was observed in the use of NOACs, independently from other clinical factors.Conclusion: The EORP-AF Long-Term General Registry provides a full picture of contemporary use of OAC in European AF patients. The overall rate of OACs use was generally high (84.9%), and a series of factors were associated with the prescription of OAC. A significant geographical heterogeneity in prescription of NOACs vs. VKAs was evident.
AB - Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed.Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84.9%), with non-vitamin K antagonists (NOACs) accounting for 40.9% of OACs. Antiplatelet therapy alone was used by 20% of patients, while no antithrombotic treatment was prescribed in 6.4%. On multivariable analysis, age, hypertension, previous ischaemic stroke, symptomatic AF and planned cardioversion or ablation were independent predictors of OAC use, whereas lone AF, previous haemorrhagic events, chronic kidney disease and admission for acute coronary syndrome (ACS) or non-cardiovascular causes independently predicted OAC non-use. Regarding the OAC type, coronary artery disease, history of heart failure, or valvular heart disease, planned cardioversion and non-AF reasons for admission independently predicted the use of vitamin K antagonists (VKAs). Wide variability among the European regions was observed in the use of NOACs, independently from other clinical factors.Conclusion: The EORP-AF Long-Term General Registry provides a full picture of contemporary use of OAC in European AF patients. The overall rate of OACs use was generally high (84.9%), and a series of factors were associated with the prescription of OAC. A significant geographical heterogeneity in prescription of NOACs vs. VKAs was evident.
KW - Journal Article
KW - Stroke
KW - Atrial fibrillation
KW - Mortality
KW - Registry
KW - Epidemiology
KW - Thromboembolic risk
UR - http://www.scopus.com/inward/record.url?scp=85046996464&partnerID=8YFLogxK
U2 - 10.1093/europace/eux301
DO - 10.1093/europace/eux301
M3 - Journal article
C2 - 29016832
SN - 1099-5129
VL - 20
SP - 747
EP - 757
JO - Europace
JF - Europace
IS - 5
ER -