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Stroke prevention in atrial fibrillation and ‘real world’ adherence to guidelines in the Balkan Region: The BALKAN-AF Survey

2016; Nature Portfolio; Volume: 6; Issue: 1 Linguagem: Inglês

10.1038/srep20432

2045-2322

Tatjana Potpara, Gheorghe‐Andrei Dan, Elina Trendafilova, A Goda, Zumreta Kušljugić, Šime Manola, Ljilja Musić, R. Musetescu, Elisabeta Bădilă, Gorana Mitić, Vilma Paparisto, Elena Dimitrova, Marija Polovina, Stanislav L Petranov, Hortensia Djergo, Daniela Lončar, Amira Bijedić, Sandro Brusich, Gregory Y.H. Lip, Tatjana Potpara, Marija Polovina, Srdjan Milanov, Marija Pavlović, Tijana Petrović, Stefan Simović, Gorana Mitić, M Milanov, J Savić, Sanja Gnip, Pavica Radović, Snežana Marković, I. Koncarevic, Jelena Gavrilović, T. Acimovic, D Djikic, Semir Malić, Jusuf Hodzic, Milovan Stojanović, M. Deljanin Ilic, M. Zlatar, Dragan Matić, S. Lazić, Vladan Perić, Sanja Špoljarić Marković, Snezana Kovacević, Aleksandra Arandjelovic, Milika Ašanin, Marija Zdravković, Gheorghe‐Andrei Dan, Anca Breha, Anca Rodica Dan, R. Musetescu, Mircea Ioachim Popescu, Elisabeta Bădilă, Cătălina Arsenescu Georgescu, Sorina Pop, Raluca Popescu, S Neamţu, Floriana Oancea, Elina Trendafilova, Elena Dimitrova, Evgenii Goshev, Anna Velichkova, Stanislav L Petranov, Delyana Kamenova, Penka Kamenova, Svetoslava Elefterova, Valentin Shterev, Maria Zekova, Stela Diukiandzhieva, Borislav Dimitrov, Tihomir Sotirov, Valentina Simeonova, Dimitrina Drianovska, Liliya Ivanova Vasileva Boiadzhieva, Darina Buchukova, A Goda, Vilma Paparisto, Hortensia Gjergo, Alma Mijo, E Shirka, Viktor Gjini, U Ekmekçiu, I Refatllari, Zumreta Kušljugić, Daniela Lončar, Denis Mršić, Hazim Tulumovic, Belma Pojskić, Alma Sijamija, Amira Bijedić, Indira Karamujic, Irma Bijedić, Sanela Halilovic, Dragan Lović, Šime Manola, Ivan Zeljković, Nikola Pavlović, Vjekoslav Radeljić, Sandro Brusich, Ante Anić, Melita Jeric, Petar Pekić, Krešimir Milas, Ljilja Musić, Nebojša Bulatović, Ana Nenezić, D Asanovic,

Venous Thromboembolism Diagnosis and Management

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.