Oral anticoagulation in patients with atrial fibrillation and acute ischaemic stroke: design and baseline data of the prospective multicentre Berlin Atrial Fibrillation Registry

Autor: Robert Stingele, Peter U. Heuschmann, Ingo Schmehl, Serdar Tütüncü, Bettina Schmitz, Frank Hamilton, Matthias Endres, Martin Honermann, Bruno-Marcel Mackert, Andrea Rocco, Janek Harder, Claudia Kunze, Johannes Schurig, Christoph Leithner, Gerhard J. Jungehulsing, Enrico Völzke, Boris Dimitrijeski, Karl Georg Haeusler, Andreas Kauert, Georg Hagemann, Florian Masuhr, Carolin Malsch, Michael von Brevern, Paul Sparenberg, Joanna Dietzel, Martin Ebinger, Darius G. Nabavi, Silke Wiedmann, Hans-Christian Koennecke
Rok vydání: 2019
Předmět:
Male
prevention & control [Brain Ischemia]
Administration
Oral

030204 cardiovascular system & hematology
Brain Ischemia
0302 clinical medicine
Interquartile range
Atrial Fibrillation
drug therapy [Atrial Fibrillation]
Prospective Studies
Registries
Stroke
Aged
80 and over

Incidence
Atrial fibrillation
Middle Aged
Vitamin K antagonist
epidemiology [Berlin]
Prognosis
Berlin
administration & dosage [Anticoagulants]
Acute Disease
Female
Cardiology and Cardiovascular Medicine
Adult
complications [Atrial Fibrillation]
medicine.medical_specialty
Adolescent
medicine.drug_class
Young Adult
03 medical and health sciences
Physiology (medical)
Internal medicine
medicine
epidemiology [Brain Ischemia]
Humans
ddc:610
Medical prescription
Aged
business.industry
Anticoagulants
Odds ratio
medicine.disease
etiology [Brain Ischemia]
Confidence interval
Heart failure
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Europace 21(11), 1621-1632 (2019). doi:10.1093/europace/euz199
ISSN: 1532-2092
1099-5129
DOI: 10.1093/europace/euz199
Popis: Aims The Berlin Atrial Fibrillation Registry was designed to analyse oral anticoagulation (OAC) prescription in patients with atrial fibrillation (AF) and acute ischaemic stroke. Methods and results This investigator-initiated prospective multicentre registry enrolled patients at all 16 stroke units located in Berlin, Germany. The ongoing telephone follow-up is conducted centrally and will cover 5 years per patient. Within 2014 and 2016, 1080 patients gave written informed consent and 1048 patients were available for analysis. Median age was 77 years [interquartile range (IQR) 72–83], 503 (48%) patients were female, and 254 (24%) had a transient ischaemic attack (TIA). Overall, 470 (62%) out of 757 patients with known AF and a (pre-stroke) CHA2DS2-VASc ≥ 1 were anticoagulated at the time of stroke. At hospital discharge, 847 (81.3%) of 1042 patients were anticoagulated. Thereof 710 (68.1%) received a non-vitamin K-dependent oral anticoagulant (NOAC) and 137 (13.1%) a vitamin K antagonist (VKA). Pre-stroke intake of a NOAC [odds ratio (OR) 15.6 (95% confidence interval, 95% CI 1.97–122)] or VKA [OR 0.04 (95% CI 0.02–0.09)], an index TIA [OR 0.56 (95% CI 0.34–0.94)] rather than stroke, heart failure [OR 0.49 (95% CI 0.26–0.93)], and endovascular thrombectomy at hospital admission [OR 12.9 (95% CI 1.59–104)] were associated with NOAC prescription at discharge. Patients’ age or AF type had no impact on OAC or NOAC use, respectively. Conclusion About 60% of all registry patients with known AF received OAC at the time of stroke or TIA. At hospital discharge, more than 80% of AF patients were anticoagulated and about 80% of those were prescribed a NOAC.
Databáze: OpenAIRE