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7. Platelet indices and stroke

Author

Yildirim, Tarik, primary, Akin, Fatih, additional, Altun, Ibrahim, additional, Yildirim, Seda Elcim, additional, Basaran, Ozcan, additional, and Soylu, Mustafa Ozcan, additional

Published
2018
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13. PRescriptiOn PattERns of Oral Anticoagulants in Nonvalvular Atrial Fibrillation (PROPER study).

Author

Basaran, Ozcan, Filiz Basaran, Nesrin, Cekic, Edip Guvenc, Altun, Ibrahim, Dogan, Volkan, Mert, Gurbet Ozge, Mert, Kadir Ugur, Akin, Fatih, Soylu, Mustafa Ozcan, Memic Sancar, Kadriye, and Biteker, Murat

Abstract

Introduction: Inappropriate use of oral anticoagulants (OACs) have not been well investigatedand, however, may be frequent in real-world practice in patients with nonvalvular atrial fibrillation (NVAF). This study was designed to evaluate the prescription patterns and appropriateness of OACs in patients with NVAF in real-world clinical settings. Methods: We performed a prospective, observational study (NCT02366338). A total of 148 patients with NVAF were screened for OAC prescription. Appropriateness of prescribing was evaluated using 9 criteria of the Medication Appropriateness Index (MAI): indication, choice, dosage, modalities and practicability of administration, drug–drug interactions, drug–disease interactions, duplication, and duration. For each criterion, the evaluator has to rate whether the medication is (A) appropriate, (B) inappropriate but with limited clinical importance, and (C) inappropriate. Results: Of 148 patients, 73 (50%) were on warfarin (group 1), 39 (26%) were on rivaroxaban (group 2), and 36 (24%) were on dabigatran therapy (group 3). The MAI showed that 83% of group 1, 28% of group 2, and 47% of group 3 patients had at least 1 inappropriate criterion. Moreover, according to the choice criterion, 37% of group 1, 8% of group 2 and 5% of group 3 were rated as inappropriate, and dosage was not appropriate in 77% of group 1, 23% of group 2, and 42% of group 3. Conclusion: Inappropriate drug use is frequent among patients with NVAF not only for warfarin but also for NOACs. Although there is an apparent improvement in thromboprophylaxis of NVAF, much more effort is needed for appropriate use of OACs. [ABSTRACT FROM AUTHOR]

Published
2017
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15. ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in non-valvular atrial fibrillation (RAMSES study)

Author

Özcan Başaran, Mehmet Yaman, Ahmet Çağrı Aykan, Mehmet Tekinalp, Ibrahim Altun, Volkan Doğan, Macit Kalçık, Özgen Şafak, Osman Beton, Onur Taşar, Murat Biteker, Ezgi Kalaycıoğlu, Ismail Bolat, Mustafa Özcan Soylu, Cevat Kirma, MÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Başaran, Özcan, Doğan, Volkan, Biteker, Murat, [Basaran, Ozcan -- Dogan, Volkan -- Altun, Ibrahim -- Soylu, Mustafa Ozcan -- Biteker, Murat] Mugla Sitki Kocman Univ, Fac Med, Dept Cardiol, Mugla, Turkey -- [Beton, Osman] Sivas Cumhuriyet Univ, Fac Med, Dept Cardiol, Sivas, Turkey -- [Tekinalp, Mehmet] Kahramanmaras Necip Fazil State Hosp, Dept Cardiol, Kahramanmaras, Turkey -- [Aykan, Ahmet Cagri -- Kalaycioglu, Ezgi] Trabzon Ahi Evren Chest Cardiovasc Surg Educ & Re, Dept Cardiol, Trabzon, Turkey -- [Bolat, Ismail] Fethiye State Hosp, Dept Cardiol, Fethiye, Turkey -- [Tasar, Onur] Elazig Educ & Res Hosp, Dept Cardiol, Elazig, Turkey -- [Safak, Ozgen] Burdur State Hosp, Dept Cardiol, Burdur, Turkey -- [Kalcik, Macit] Iskilip Atif Hoca State Hosp, Dept Cardiol, Corum, Turkey -- [Yaman, Mehmet] Samsun Educ & Res Hosp, Dept Cardiol, Samsun, Turkey -- [Kirma, Cevat] Kartal Kosuyolu Heart Educ & Res Hosp, Dept Cardiol, Istanbul, Turkey, Demir, Vahit -- 0000-0001-8349-6651, and BASARAN, OZCAN -- 0000-0002-6384-6455

Subjects
medicine.medical_specialty, Turkey, Non valvular atrial fibrillation, Administration, Oral, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, prevention, Risk Factors, Internal medicine, Surveys and Questionnaires, Atrial Fibrillation, medicine, Humans, Oral Anticoagulant Therapy, Medical history, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, Mitral regurgitation, Univariate analysis, business.industry, Prevention, Hot Topic, Anticoagulants, Atrial fibrillation, oral anticoagulant therapy, Middle Aged, medicine.disease, stroke, Cross-Sectional Studies, Stroke prevention, Multicenter survey, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

WOS: 000392195800004, PubMed ID: 27723665, Objective: Data regarding stroke prevention strategies in non-valvular atrial fibrillation (NVAF) are limited to vitamin K antagonists (VKAs). This study aimed to evaluate real-life stroke prevention strategies for NVAF patients in the era of non-VKA oral anticoagulants (NOACs). Methods: We established a cross-sectional, multicenter, nationwide registry of NVAF patients. All consecutive atrial fibrillation (AF) patients and without mechanical heart valves or rheumatic mitral stenosis (but including those with any degree of mitral regurgitation) were enrolled in the ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies (RAMSES Study; ClinicalTrials. gov identifier NCT02344901) in Turkey. Base-line demographic data, medical history, and medications prescribed for NVAF treatment were collected. Univariate analyses were performed for continuous variables, and the chi-square test was used for categorical variables. Results: In total, 6273 patients from 29 provinces of Turkey were enrolled in the study between February and May 2015, with the contribution of 83 investigators. The mean age was 69.6 +/- 10.7 years; 56% of the patients were females, and one-fifth of the patients had at least one comorbid disease, the most common being hypertension (69%). The mean CHA(2)DS(2)-VASc and HAS-BLED scores were 3.3 +/- 1.6 and 1.6 +/- 1.1, respectively. The rate of oral anticoagulant (OAC) therapy use was 72% (37% NOAC and 35% VKA). Conclusion: The RAMSES study showed a higher prevalence of OAC use among NVAF patients than that reported in previous studies. Although NOACs were preferred over VKAs in daily cardiology practice, there is a need for improved OAC therapies for NVAF patients.

Published
2016

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