1. Oral anticoagulation in patients with atrial fibrillation and acute ischaemic stroke: design and baseline data of the prospective multicentre Berlin Atrial Fibrillation Registry
- Author
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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, and Hans-Christian Koennecke
- Subjects
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 - Abstract
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.
- Published
- 2019
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