Epidemiology of atrial fibrillation in Turkey: preliminary results of the multicenter AFTER study

Ertaş, Faruk; Kaya, Hasan; Kaya, Zekeriya; Bulur, Serkan; Köse, Nuri; Gül, Mehmet; Eren, Nihan Kahya; Çağlıyan, Çağlar Emre; Köroğlu, Bayram; Vatan, Bülent; Açar, Göksel; Yüksel, Murat; Bilik, Mehmet Zihni; Gedik, Selçuk; Şimşek, Ziya; Akıl, Mehmet Ata; Yılmaz, Rüstem; Oylumlu, Mustafa; Arıbaş, Alpay; Yıldız, Abdülkadir; Aydın, Mesut; Yeter, Ekrem; Kanadaşı, Mehmet; Ergene, Oktay; Özhan, Hakan; Ülgen, Mehmet Sıddık

doi:10.5543/tkda.2013.18488

Cited by 18 publications

(17 citation statements)

References 15 publications

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“…The TTR values may vary between countries in patients VKA therapy ( 7 , 8 ). In our country, the rate of TTR is lower than expected, and differences between geographical regions remain unknown for the time being ( 9 , 10 , 11 ). However, the ROCKET-AF study reported that TTR rates may vary among geographical regions ( 12 ).…”

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confidence: 61%

“…Previous studies in Turkey noted low TTR values in this country. The AFTER study, which included 2242 patients with at least one AF attack from 17 different centres in Turkey, reported non-valvular AF (NVAF) and effective INR levels as 78% and 41.3%, respectively ( 10 ). In the WATER (Warfarin in Therapeutic Range) study, the mean TTR value was 42.3%±18 in 572 patients with AF (71% NVAF) during 22-month follow-up ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

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The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study

Çelik¹,

Çakmak²,

Afşin³

et al. 2017

Balkan Med J

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Background: The time in therapeutic range values may vary between different geographical regions of Turkey in patients vitamin K antagonist therapy.Aims: To evaluate the time in therapeutic range percentages, efficacy, safety and awareness of warfarin according to the different geographical regions in patients who participated in the WARFARIN-TR study (The Awareness, Efficacy, Safety and Time in Therapeutic Range of Warfarin in the Turkish population) in Turkey.Study Design: Cross-sectional study.Methods: The WARFARIN-TR study includes 4987 patients using warfarin and involved regular international normalized ratio monitoring between January 1, 2014 and December 31, 2014. Patients attended follow-ups for 12 months. The sample size calculations were analysed according to the density of the regional population and according to Turkish Statistical Institute data. The time in therapeutic range was calculated according to F.R. Roosendaal’s algorithm. Awareness was evaluated based on the patients’ knowledge of the effect of warfarin and food-drug interactions with simple questions developed based on a literature review. Results: The Turkey-wide time in therapeutic range was reported as 49.5%±22.9 in the WARFARIN-TR study. There were statistically significant differences between regions in terms of time in therapeutic range (p<0.001). The highest rate was reported in the Marmara region (54.99%±20.91) and the lowest was in the South-eastern Anatolia region (41.95±24.15) (p<0.001). Bleeding events were most frequently seen in Eastern Anatolia (41.6%), with major bleeding in the Aegean region (5.11%) and South-eastern Anatolia (5.36%). There were statistically significant differences between the regions in terms of awareness (p<0.001).Conclusion: Statistically significant differences were observed in terms of the efficacy, safety and awareness of warfarin therapy according to different geographical regions in Turkey.

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confidence: 61%

Section: Discussionmentioning

confidence: 99%

The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study

Çelik¹,

Çakmak²,

Afşin³

et al. 2017

Balkan Med J

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“…In the AFTER study, it was shown that the TTR level was detected in 41.3% of the patients with AF in Turkey (16). On the other hand, patients treated with warfarin were outside the INR target range 32.1% of the time in British population (3).…”

Section: Discussionmentioning

confidence: 99%

The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: warfarin -tr

Çelik¹,

İzcı²,

Kobat³

et al. 2015

Anatol J Cardiol

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Objective:The awareness, time in therapeutic range (TTR), and safety of warfarin therapy were investigated in the adult Turkish population.Methods:This multicenter prospective study includes 4987 patients using warfarin and involved regular international normalized ratio (INR) monitoring between January 1, 2014 and December 31, 2014. TTR was calculated according to F.R. Roosendaal’s algorithm. Awareness was evaluated based on the patients’ knowledge of warfarin’s affect and food–drug interactions.Results:The mean TTR of patients was 49.52±22.93%. The patients with hypertension (55.3%), coronary artery disease (23.2%), congestive heart failure (24.5%), or smoking habit (20.8%) had significantly lower TTR levels than the others. Of the total number of patients, 42.6% had a mechanical valve, 38.4% had non-valvular atrial fibrillation (AF), and 19% had other indications for warfarin. Patients with other indications had lower TTR levels than those with mechanical valve and non-valvular AF (p=0.018). Warfarin awareness decreased in higher age groups. The knowledge of warfarin’s food–drug interactions was 55%. People with higher warfarin awareness had higher TTR levels. Patients with ≤8 INR monitoring/year had lower TTR levels (46.4±25.3 vs. 51.1±21.3, respectively, p<0.001) and lower awareness (44.6% vs. 60.6%, p<0.001) than patients with ≥8 INR monitoring/year. In this study, 20.1% of the patients had a bleeding event (major bleeding 15.8%, minor bleeding 84.2%) within a year.Conclusion:Both the mean TTR ratios and awareness of the Turkish population on warfarin therapy were found to be low. It was thought that low TTR levels of the Turkish population may be caused by the low awareness of warfarin, warfarin’s food–drug interactions, and high rates of concomitant diseases. (Anatol J Cardiol 2016; 16: 595-600)

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“…There are several predictors of PAF, such as hypertension, heart failure, valvular heart disease, and hyperthyroidism (14, 15). In our previous multicenter study, the Atrial Fibrillation Registry in Turkey (AFTER), we found that hypertension was the most common comorbid condition in patients with AF (16, 17). In fact, an increased P wave duration on standard 12-lead ECG indicates the presence of an atrial conduction disorder (18).…”

Section: Discussionmentioning

confidence: 99%

The relationship between atrial electromechanical delay and left atrial mechanical function in stroke patients

Akıl¹,

Akıl²,

Bilik³

et al. 2015

Anatol J Cardiol

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Objective:The aim of this study was to evaluate the relationship between atrial electromechanical delay (EMD) measured with tissue Doppler imaging (TDI) and left atrial (LA) mechanical functions in patients with ischemic stroke and compare them with healthy controls.Methods:Thirty patients with ischemic stroke were enrolled into this cross-sectional, observational study. The control group consisted of 35 age- and gender-matched apparently healthy individuals patients. Acute cerebral infarcts of probable embolic origin were diagnosed via imaging and were confirmed by a neurologist. Echocardiographically, time intervals from the beginning of P wave to beginning of A wave from the lateral and septal mitral and right ventricular tricuspid annuli in TDI were recorded. The differences between these intervals gave the mechanical delays (inter- and intra-atrial). Left atrial (LA) volumes were measured using the biplane area-length method, and LA mechanical function parameters were calculated. Statistical analysis was performed using student’s t-test, chi-squared test, and Pearson’s test.Results:The laboratory and clinical characteristics were similar in the two groups. Increased left atrial EMD (21.36±10.38 ms versus 11.74±6.06 ms, p<0.001), right atrial EMD (13.66±8.62 ms versus 9.66±6.81 ms, p=0.040), and interatrial EMD (35.03±9.95 ms versus 21.40±8.47 ms, p<0.001) were observed in stroke patients as compared to controls. Active LA emptying volume and fraction and passive LA emptying volumes and fraction were similar between controls and stroke patients. Total LA emptying volumes were significantly increased in stroke patients as compared to healthy controls (33.19±11.99 mL/m2 versus 27.48±7.08 mL/m2, p=0.021).Conclusion:According to the results of our study, interatrial electromechanical delay may be a new predictor for ischemic stroke.

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Epidemiology of atrial fibrillation in Turkey: preliminary results of the multicenter AFTER study

Abstract: These results demonstrate the necessity for improved quality of physician care of patients with AF, especially with regards to antithrombotic therapy.

Cited by 18 publications

References 15 publications

The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study

The Time in Therapeutic Range and Bleeding Complications of Warfarin in Different Geographic Regions of Turkey: A Subgroup Analysis of WARFARIN-TR Study

The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: warfarin -tr

The relationship between atrial electromechanical delay and left atrial mechanical function in stroke patients

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