Management of patients with newly-diagnosed atrial fibrillation: Insights from the BALKAN-AF survey. (February 2020)

• Record Type: Journal Article
• Authors: Kozieł, Monika; Simovic, Stefan; Pavlovic, Nikola; Nedeljkovic, Milan; Paparisto, Vilma; Music, Ljilja; Goshev, Evgenii; Dan, Anca Rodica; Manola, Sime; Kusljugic, Zumreta; Trendafilova, Elina; Dobrev, Dobromir; Dan, Gheorghe-Andrei; Lip, Gregory Y.H.; Potpara, Tatjana S.
• Is Part Of: IJC heart & vasculature. Volume 26(2020)
• Publication Date: 2020-02
• Subjects: Atrial fibrillation -- First-diagnosed atrial fibrillation -- BALKAN-AF survey -- Oral anticoagulants -- Rate control -- Rhythm control; Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Pathophysiology -- Periodicals; 616.1005
• DOI: 10.1016/j.ijcha.2019.100461
• Languages: English
• ISSNs: 2352-9067

Abstract

Highlights: 23.6% of patients in the survey had newly-diagnosed atrial fibrillation (AF). Those patients had different risk profiles than those with a history of AF. The specificity of the management of first-diagnosed AF patients was presented. Abstract: Background: BALKAN-AF evaluated patterns of atrial fibrillation (AF) management in real-world clinical practice in the Balkans. The objectives were: to assess the proportion of patients with first-diagnosed AF in the BALKAN-AF cohort and to compare the management of patients with newly-diagnosed AF and those with previously known AF in clinical practice. Methods: Consecutive patients from 7 Balkan countries were enrolled prospectively to the snapshot BALKAN-AF survey. Results: Of 2712 enrolled patients, 2677 (98.7%) with complete data were included. 631 (23.6%) patients had newly-diagnosed AF and 2046 (76.4%) patients had known AF. Patients with newly-diagnosed AF were more likely to be hospitalized for AF and to receive single antiplatelet therapy (SAPT) alone and less likely to receive OACs than those with known AF (all p < 0.001). The use of OAC was not significantly associated with the CHA2 DS2 -VASc (p = 0.624) or HAS-BLED score (p = 0.225) on univariate analysis. Treatment in capital city, hypertension, dilated cardiomyopathy, mitral valve disease, country of residence or rate control strategy were independent predictors of OAC use, whilst non-emergency centre, treatment by cardiologist, paroxysmal AF, palpitations, symptoms attributable to AF (as judged by physician), mean heart rate and AF as the main reason for hospitalization were independent predictors of rhythm control strategy use. Conclusions: In BALKAN-AF survey, patients with newly-diagnosed AF were more often hospitalized, less often received OAC and were more likely to receive SAPT alone. The use of OAC for stroke prevention has not been driven by the individual patient stroke risk.