ISSN 1016-5169 | E-ISSN 1308-4488
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Real-World Evaluation of Anticoagulant Treatment Patterns in Patients with Atrial Fibrillation: Data from Multicenter ROTA Study [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2023; 51(2): 88-96 | DOI: 10.5543/tkda.2022.98455

Real-World Evaluation of Anticoagulant Treatment Patterns in Patients with Atrial Fibrillation: Data from Multicenter ROTA Study

Umut Kocabaş1, Işıl Ergin2, Veysel Yavuz3, Selda Murat4, Ibrahim Özdemir5, Ömer Genç6, Cihan Altın7, Haşim Tüner8, Bengisu Keskin Meriç9, Ali Çoner10, Elif İlkay Yüce11, Bedrettin Boyraz12, Onur Aslan13, Ahmet Dal7, Taner Şen14, Ersin İbişoğlu15, Aslan Erdoğan15, Mehmet Özgeyik16, Mevlüt Demir14, Ziya Gökalp Bilgel17, Büşra Güvendi Şengör18, Örsan Deniz Urgun19, Mustafa Doğduş20, Deniz Dilan Naki Tekin15, Sinem Çakal21, Sercan Çayırlı22, Arda Güler23, Dilay Karabulut24, Onur Dalgıç25, Osman Uzman26, Bektaş Murat16, Şeyda Şahin27, Umut Karabulut28, Tarık Kıvrak29, Muharrem Said Coşgun30, Ferhat Özyurtlu31, Mehmet Kaplan32, Emre Özçalık1
1Başkent University Izmir Hospital, Department of Cardiology, Izmir, Türkiye
2Ege University, Faculty of Medicine, Department of Public Health, Izmir, Türkiye
3Akhisar State Hospital, Department of Cardiology, Manisa, Türkiye
4Eskişehir Osmangazi University, Faculty of Medicine, Department of Cardiology, Eskişehir, Türkiye
5Manisa City Hospital, Department of Cardiology, Manisa, Türkiye
6Ağrı Training and Research Hospital, Department of Cardiology, Ağrı, Türkiye
7Izmir University of Economics, Faculty of Medicine, Department of Cardiology, Izmir, Türkiye
8Hakkari State Hospital, Department of Cardiology, Hakkari, Türkiye
9Babaeski State Hospital, Department of Cardiology, Kırklareli, Türkiye
10Başkent University Alanya Hospital, Department of Cardiology, Antalya, Türkiye
11Fethiye State Hospital, Department of Cardiology, Muğla, Türkiye
12Tatvan State Hospital, Department of Cardiology, Bitlis, Türkiye
13Mersin City Hospital, Department of Cardiology, Mersin, Türkiye
14Kütahya Health Sciences University, Faculty of Medicine, Department of Cardiology, Kütahya, Türkiye
15Başakşehir Çam and Sakura City Hospital, Department of Cardiology, Istanbul, Türkiye
16Eskişehir City Hospital, Department of Cardiology, Eskişehir, Türkiye
17Başkent University Adana Hospital, Department of Cardiology, Adana, Türkiye
18Maltepe State Hospital, Department of Cardiology, Istanbul, Türkiye
19Kozan State Hospital, Department of Cardiology, Adana, Türkiye
20Uşak University Training and Research Hospital, Department of Cardiology, Uşak, Türkiye
21Health Sciences University, Haseki Training and Research Hospital, Department of Cardiology, Istanbul, Türkiye
22Adnan Menderes University, Faculty of Medicine, Department of Cardiology, Aydın, Türkiye
23Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Türkiye
24Istanbul Bakirköy Dr Sadi Konuk Training and Research Hospital, Department of Cardiology, Istanbul, Türkiye
25Kardiya Medical Center, Department of Cardiology, Izmir, Türkiye
26Sarıkamış State Hospital, Department of Cardiology, Kars, Türkiye
27Turhal State Hospital, Department of Cardiology, Tokat, Türkiye
28Istanbul Acıbadem International Hospital, Department of Cardiology, Istanbul, Türkiye
29Elazığ Fırat University, Faculty of Medicine, Department of Cardiology, Elazığ, Türkiye
30Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Department of Cardiology, Erzincan, Türkiye
31Grandmedical Hospital, Department of Cardiology, Manisa, Türkiye
32Gaziantep University, Faculty of Medicine, Department of Cardiology, Gaziantep, Türkiye


OBJECTIVE
Oral anticoagulant therapy is the cornerstone of atrial fibrillation management to prevent stroke and systemic embolism. However, there is limited real-world information regarding stroke and systemic embolism prevention strategies in patients with atrial fibrillation. The aim of the ROTA study is to obtain the real-world data of anticoagulant treatment patterns in patients with atrial fibrillation.


METHODS
The ROTA study is a prospective, multicenter, and observational study that included 2597 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January 2021 and May 2021.


RESULTS
The median age of the study population was 72 years (range: 22-98 years) and 57.4% were female. The median CHA2DS2-VASc and HAS-BLED scores were 4 (range: 0-9) and 1 (range: 0-6), respectively. Vitamin K antagonists and direct oral anticoagulants were used in 15.9% and 79.4% of patients, respectively. The mean time in therapeutic range was 52.9% for patients receiving vitamin K antagonists, and 76% of those patients had an inadequate time in therapeutic range with <70%. The most common prescribed direct oral anticoagulants were rivaroxaban (38.1%), apixaban (25.5%), and edoxaban (11.2%). The rate of overuse of vitamin K antagonists and direct oral anticoagulants was high (76.1%) in patients with low stroke risk, and more than one-fourth of patients on direct oral anticoagulant therapy were receiving a reduced dose of direct oral anticoagulants. Among patients who were on direct oral anticoagulant treatment, patients with apixaban treatment were older, had higher CHA2DS2-VASc and HAS-BLED scores, and had lower creatinine clearance than the patients receiving other direct oral anticoagulants.


CONCLUSIONS
The ROTA study provides important real-world information about anticoagulant treatment patterns in patients with atrial fibrillation.time in therapeutic range with <70%.

Keywords: Atrial fi, brillation, anticoagulation, direct oral anticoagulants, stroke, systemic embolism.

How to cite this article
Umut Kocabaş, Işıl Ergin, Veysel Yavuz, Selda Murat, Ibrahim Özdemir, Ömer Genç, Cihan Altın, Haşim Tüner, Bengisu Keskin Meriç, Ali Çoner, Elif İlkay Yüce, Bedrettin Boyraz, Onur Aslan, Ahmet Dal, Taner Şen, Ersin İbişoğlu, Aslan Erdoğan, Mehmet Özgeyik, Mevlüt Demir, Ziya Gökalp Bilgel, Büşra Güvendi Şengör, Örsan Deniz Urgun, Mustafa Doğduş, Deniz Dilan Naki Tekin, Sinem Çakal, Sercan Çayırlı, Arda Güler, Dilay Karabulut, Onur Dalgıç, Osman Uzman, Bektaş Murat, Şeyda Şahin, Umut Karabulut, Tarık Kıvrak, Muharrem Said Coşgun, Ferhat Özyurtlu, Mehmet Kaplan, Emre Özçalık. Real-World Evaluation of Anticoagulant Treatment Patterns in Patients with Atrial Fibrillation: Data from Multicenter ROTA Study. Turk Kardiyol Dern Ars. 2023; 51(2): 88-96

Corresponding Author: Umut Kocabaş, Türkiye
Manuscript Language: English


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