Clinical research study‘Real-World’ Antithrombotic Treatment in Atrial Fibrillation: The EORP-AF Pilot Survey
Section snippets
Materials and Methods
The full baseline features and results from the EORP-AF Pilot Survey have been published.11 In this ancillary analysis, we focused on the clinical features associated with antithrombotic therapy use. In brief, the registry population comprised consecutive inpatients and outpatients with atrial fibrillation presenting to cardiologists in participating ESC countries. Consecutive patients were screened for eligibility at the time of their presentation to a cardiologist (hospital or medical
Results
We enrolled 3119 patients from February 2012 to March 2013. Table 1 shows the characteristics versus antithrombotic drug use of patients admitted to the hospital in whom no pharmacologic or electrical cardioversion and catheter ablation were performed or planned. In the whole cohort, when oral anticoagulation was used, vitamin K antagonist therapy was prescribed in the majority (651/902 = 72.2%), whereas novel oral anticoagulants were used in the minority (69/902 = 7.7%). No antithrombotic
Discussion
In this report from the EORP-AF Pilot Survey, we found that oral anticoagulation often was used for atrial fibrillation, especially when heart failure or other cardiac diseases were present. However, antiplatelet therapy still was prescribed routinely with or without oral anticoagulation when there was coexistent myocardial infarction or coronary artery disease. Oral anticoagulation was prescribed less often in elderly patients, and antiplatelet therapy alone was prescribed more commonly. When
Conclusions
The EORP-AF Pilot Survey provides contemporary data on oral anticoagulation prescribing by European cardiologists for atrial fibrillation. Although the uptake of oral anticoagulation (mostly vitamin K antagonist therapy) has improved since the Euro Heart Survey a decade ago, antiplatelet therapy still is prescribed routinely with or without oral anticoagulation, whereas elderly patients often are undertreated with oral anticoagulation.
Acknowledgments
Executive steering committee, Steering Committee (National Coordinators), and Study Investigators were listed in the primary article describing the baseline data, by Lip et al.11 Data monitor and technical support team: Data collection was conducted by the EURObservational Research Program department from the European Cardiac Society by Viviane Missiamenou. Statistical analyses were performed by Cécile Laroche with the support of Renato Urso. Overall activities were coordinated by Aldo P.
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Cited by (139)
Systematic review of treatment gaps in oral anticoagulant use in atrial fibrillation
2021, Thrombosis UpdateAntithrombotic Therapy in Atrial Fibrillation Management in Western Australia: Temporal Trends and Evidence-Treatment Gaps
2021, Heart Lung and CirculationCitation Excerpt :In our study, younger patients at lower stroke risk were more likely to be prescribed a NOAC than elderly high-risk patients. Possible reasons underlying OAC under-use in high-risk patients could include patient preference, inadequate awareness of evidence-based guidelines and an over-emphasis on bleeding risk by physicians [11,17,18]. The majority of patients in our study were predicted at high risk of both stroke and bleeding.
Funding: None.
Conflict of Interest: GYHL is a consultant for Bayer, Medtronic, Sanofi, BMS/Pfizer, Daiichi-Sankyo, and Boehringer Ingelheim, and has been a speaker for Bayer, BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, and Medtronic. LHR is on the speakers bureaus for Bayer, BMS/Pfizer, Janssen Pharmaceuticals, Takeda, Roche Diagnostics, and Boehringer Ingelheim. GB has received small speaker's fees from Medtronic Inc and Boston Scientific. The remaining authors do not have any conflicts of interest associated with the work presented in this manuscript. EURObservational Research Programme Sponsors: At the time of the registry, the following companies were supporting the EURObservational Research Programme: GOLD: Abbott Vascular, Bayer Pharma, Bristol Myers Squibb (BMS), Pfizer, Boehringer Ingelheim, Daiichi Sankyo Europe, Menarini International Operations, Novartis Pharma, Sanofi-Aventis, Servier International. SILVER: Amgen. BRONZE: Boston Scientific International, Merck & Co (MSD).
Authorship: All authors had access to the data and played a role in writing this manuscript.