Stroke Prevention in Atrial Fibrillation and 'real World' Adherence to Guidelines in the Balkan Region: The BALKAN-AF Survey

Overview

Journal Sci Rep

Specialty Science

Date 2016 Feb 13

PMID 26869284

Citations 24

Authors

Tatjana S Potpara

Gheorghe-Andrei Dan

Elina Trendafilova

Artan Goda

Zumreta Kusljugic

Sime Manola

Ljilja Music

Rodica Musetescu

Elisabeta Badila

Gorana Mitic

Vilma Paparisto

Elena S Dimitrova

Marija M Polovina

Stanislav L Petranov

Hortensia Djergo

Daniela Loncar

Amira Bijedic

Sandro Brusich

Gregory Y H Lip

Affiliations

Soon will be listed here.

Abstract

Data on the management of atrial fibrillation (AF) in the Balkan Region are limited. The Serbian AF Association (SAFA) prospectively investigated contemporary 'real-world' AF management in clinical practice in Albania, Bosnia&Herzegovina, Bulgaria, Croatia, Montenegro, Romania and Serbia through a 14-week (December 2014-February 2015) prospective, multicentre survey of consecutive AF patients. We report the results pertinent to stroke prevention strategies. Of 2712 enrolled patients, 2663 (98.2%) with complete data were included in this analysis (mean age 69.1 ± 10.9 years, female 44.6%). Overall, 1960 patients (73.6%) received oral anticoagulants (OAC) and 762 (28.6%) received antiplatelet drugs. Of patients given OAC, 17.2% received non-vitamin K antagonist oral anticoagulants (NOACs). CHA2DS2-VASc score was not significantly associated with OAC use. Of the 'truly low-risk' patients (CHA2DS2-VASc = 0 [males], or 1 [females]) 56.5% received OAC. Time in Therapeutic Range (TTR) was available in only 18.7% of patients (mean TTR: 49.5% ± 22.3%). Age ≥ 80 years, prior myocardial infarction and paroxysmal AF were independent predictors of OAC non-use. Our survey shows a relatively high overall use of OAC in AF patients, but with low quality of vitamin K antagonist therapy and insufficient adherence to AF guidelines. Additional efforts are needed to improve AF-related thromboprophylaxis in clinical practice in the Balkan Region.

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