Journal
EUROPACE
Volume 20, Issue 5, Pages 747-757Publisher
OXFORD UNIV PRESS
DOI: 10.1093/europace/eux301
Keywords
Atrial fibrillation; Epidemiology; Thromboembolic risk; Stroke; Mortality; Registry
Categories
Funding
- Abbott Vascular Int.
- Amgen Cardiovascular
- AstraZeneca
- Bayer AG
- Boehringer Ingelheim
- Boston Scientific
- Bristol Myers Squibb
- Pfizer Alliance
- Alliance Daiichi Sankyo Europe GmbH
- Eli Lilly and Company
- Edwards Gedeon Richter Plc.
- Menarini Int. Op.
- MSD-Merck Co.
- Novartis Pharma AG
- ResMed
- Sanofi
- SERVIER
- Bristol Myers Squibb/Pfizer Alliance
- German Centre for Cardiovascular Research (DZHK)
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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.
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