Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation: a report from the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) Long-Term General Registry

EP Europace Journal

14 September 2017
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ESC Journals

Abstract

AbstractAims

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.

Contributors

Giuseppe Boriani
Giuseppe Boriani

Author

Modena Polyclinic Modena University Hospital Modena , Italy

H Hötz
H Hötz

Author

T Patel
T Patel

Author

E Young
E Young

Author

J Law
J Law

Author

H Thomas
H Thomas

Author

B Schön
B Schön

Author

H McKie
H McKie

Author

N Schön
N Schön

Author

J Fuller
J Fuller

Author

S Pick
S Pick

Author

G-A Dan
G-A Dan

Author

A Sharp
A Sharp

Author

A Hunt
A Hunt

Author

F Marin
F Marin

Author

K Thorpe
K Thorpe

Author

G Baytok
G Baytok

Author

E Cusack
E Cusack

Author

L Adams
L Adams

Author

M Hough
M Hough

Author

S Keenan
S Keenan

Author

A Gerth
A Gerth

Author

A Goda
A Goda

Author

J Watts
J Watts

Author

J Zaman
J Zaman

Author

K Goffin
K Goffin

Author

H Nutt
H Nutt

Author

J Brunn
J Brunn

Author

C Mills
C Mills

Author

K Foth
K Foth

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S Grant
S Grant

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A Wilson
A Wilson

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S Riahi
S Riahi

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I Alam

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P Muda

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