Epidemiological approach to the atrial fibrillation patients

Atrial fibrilasyon (AF) klinik pratikte en sık görülen arit midir. En korkulan komplikasyonu tromboembolik olaylar olup tüm inmelerin % 15’inden tek başına sorumludur. AF’nin yol açtığı bu önemli komplikasyonu önlemenin en etkin yolu antikoagulasyondur. Antikoagülasyonu sağla mak için son dönemlerde ortaya çıkan yeni oral antiko agülanlarla ilgili çekincelerden dolayı altın standart ajan olarak warfarin hala üstünlüğünü sürdürmektedir. Efektif antikoagülasyon sağlamada kullanılan farmakolojik ajan- ların yanı sıra hastanın demografik özellikleri de (yaş, cinsiyet, AF tipi, komorbid durumlar vb.) büyük önem ta- şımaktadır. AF hastalarının demografik karakteristiği ve oral antikoagülan ilaç kullanım profili ile ilgili yapılan çalış- malar çoğunlukla Batı ve Uzakdoğu kökenli olduğundan ülkemizin gerçek karakteristiğini yansıtmamaktadır. Bu çalışmayla ülkemizde AF hastalarında yapılmış olan epi- demiyolojik çalışmalar analiz edilerek toplumumuz ile ilgili verileri literatüre kazandırmayı amaçladık.

Atriyal fibrilasyon hastalarına epidemiyolojik yaklaşım

Atrial Fibrillation (AF) is the most common arrhythmia observed in clinical practice. While the thromboembolic events are the most feared complications, these com plications alone are responsible for 15% of all strokes. Anticoagulation therapy is the most effective way to pre vent this significant complication caused by AF. Due to the disadvantages related to the recently launched new oral anticoagulants, warfarin still maintains its dominance as the gold standard agent. Pharmaceutical agents as well as demographic characteristics (age, sex, the type of AF, co-morbidities etc.) of the patients are crucial to provide effective coagulation. Since most of the studies on demographic characteristics of AF patients and the profile of oral anticoagulant use originate from the West and Far East, they do not reflect the real characteristics of our country. In this study, by analyzing the epidemiologi cal studies conducted among AF patients in our country, we aimed to bring literature in data related to our society.

___

  • 1. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diag nosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the An Tico agulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-2375.
  • 2. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibril lation: the Task Force for the Management of Atrial Fibril lation of the European Society of Cardiology (ESC). Eur Heart J 2010;31:2369-2429.
  • 3. Warfarin versus aspirin for prevention of thromboembolism in atrial fibrillation: Stroke Prevention in Atrial Fibrillation II Study. Lancet 1994;343:687-691.
  • 4. Rockson SG, Albers GW. Comparing the guidelines: antico agulation therapy to optimize stroke prevention in patients with atrial fibrillation. J Am Coll Cardio.l 2004;43: 929- 935.
  • 5. Atarashi H, Inoue H, Okumura K, et al. J-RHYTHM Reg- istry Investigators. Present status of anticoagulation treat ment in Japanese patients with atrial fibrillation: a report from the J-RHYTHM Registry. Circ J 2011;75:1328-1333.
  • 6. Waldo AL, Becker RC, Tapson VF, Colgan KJ; NABOR Steering Committee. Hospitalized patients with atrial fibril lation and a high risk of stroke are not being provided with adequate anticoagulation. J Am Coll Cardiol 2005;46:1729- 1736.
  • 7. Nabauer M, Gerth A, Limbourg T, et al. The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management. Europace 2009;11:423-434.
  • 8. Shin HW, Kim YN, Bae HJ, et al. KORAF Investigator. Trends in Oral Anticoagulation Therapy Among Korean Patients With Atrial Fibrillation: The KORean Atrial Fibril lation Investigation. Korean Circ J 2012;42:113-117.
  • 9. Goto S, Bhatt DL, Röther J, et al. REACH Registry Investi gators.Prevalence, clinical profile, and cardiovascular out comes of atrial fibrillation patients with atherothrombosis. Am Heart J 2008;156:855-863
  • 10. Benjamin EJ, Levy D, Vaziri SM, et al. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 1994;271:840-844.
  • 11. Psaty BM, Manolio TA, Kuller LH, et al. Incidence of and risk factors for atrial fibrillation in older adults. Circulation 1997;96:2455-2461.
  • 12. Inoue H, Fujiki A, Origasa H, et al. Prevalence of atrial fibrillation in the general population of Japan: an analysis based on periodic health examination. Int J Cardiol 2009; 137:102-107
  • 13. Lok NS, Lau CP. Prevalence of palpitations, cardiac ar rhythmias and their associated risk factors in ambulant el derly. Int J Car-diol 1996;54:231-236.
  • 14. Uyarel H, Onat A, Yüksel H, Can G, Ordu S, Dursunoğlu D. Incidence, prevalence, and mortality estimates for chronic atrial fibrillation in Turkish adults. Turk Kardiyol Dern Ars 2008;36:214-222.
  • 15. Karaçağlar E, Atar I, Yetiş B, et al. The frequency of em bolic risk factors and adequacy of anti-embolic treatment in patients with atrial fibrillation: a single tertiary center expe
  • 16. Buse JB, Ginsberg HN, Bakris GL, et al. American Diabetes Association. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation 2007;1151:114-126
  • 17. Ertaş F, Kaya H, Kaya Z, et al. Epidemiology of Atrial Fi brillation in Turkey: Preliminary Results of the Multicenter AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) Study. Turk Kardiyol Dern Ars doi: 10.5543/ tkda.2013.18488
  • 18. Ertaş F, Kaya H, Yüksel M, et al. Atrial Fibrillation in Tur key: Epidemiologic Registry (AFTER) Study Design. An adolu Kardiyol Derg (in press)
  • 19. Saksena S, Slee A, Waldo AL, et al. Cardiovascular out comes in the AFFIRM Trial (Atrial Fibrillation Follow-Up Investigation of Rhythm Management). An assessment of individual antiarrhythmic drug therapies compared with rate control with propensity score-matched analyses. J Am Coll Cardiol 2011;58:1975-1985
  • 20. Nieuwlaat R, Capucci A, Camm AJ, et al. European Heart Survey Investigators. Atrial fibrillation management: a pro spective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation. Eur Heart J 2005;26:2422- 2434.
  • 21. Ertaş F, Duygu H, Acet H, Eren NK, Nazli C, Ergene AO. Oral anticoagulant use in patients with atrial fibrillation. Turk Kardiyol Dern Ars 2009;37:161-167.
  • 22. Ertaş F, Kaya H, Atılgan ZA, et al. Predictors of warfa rin use in patients with non-valvular atrial fibrillation who presented to the cardiology outpatient clinic of a tertiary hospital in Turkey: an observational study. Turk J Med Sci 2012;42:1172-1179.
  • 23. Falk RH. Etiology and complications of atrial fibrillation: insights from pathology studies. Am J Cardiol 1998;82: 10N-17N. Review.
  • 24. TAF Araştırıcıları adına Z. Yiğit. Türk Atriyal Fibrilasyon (TAF) Çalışması Non-valvüler Atriyal Fibrilasyonlu Has talarda Antikoagülan ve Aspirin’in Tromboembolik Risk Üzerine Etkilerinin Karşılaştırıldığı Çok Merkezli, Rando mize Çalışma Türk Kardiyol Dern Arş 2000;28:8-1.
  • 25. Schnabel RB, Wilde S, Wild PS, et al. Atrial fibrillation: its prevalence and risk factor profile in the German general population. Dtsch Arztebl Int 2012;109:293-299.
  • 26. Bover R, Pérez-Gómez F, Maluenda MP, et al. Long-term follow-up of atrial fibrillation patients in the NASPEAF study. Prospective evaluation of different antiplatelet treat ments. Rev Esp Cardiol 2009;62:992-1000.
  • 27. Connolly SJ, Ezekowitz MD, Yusuf S, et al. RE-LY Steer ing Committee and Investigators. Dabigatran versus war farin in patients with atrial fibrillation. N Engl J Med 2009;361:1139-1151.
  • 28. Paikin JS, Manolakos JJ, Eikelboom JW.Rivaroxaban for stroke prevention in atrial fibrillation: a critical review of the ROCK-ET AF trial. Expert Rev Cardiovasc Ther 2012;10: 965-972.
  • 29. Lopes RD, Al-Khatib SM, et al. Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a sec ondary analysis of a randomised controlled trial. Lancet 2012;380:1749-1758.
  • 30. J-RHYTHM Registry Investigators. Determinants of warfa rin use and international normalized ratio levels in atrial fi brillation patients in Japan. Subanalysis of the J-RHYTHM Registry. Circ J 2011;75:2357-2362.
  • 31. Baczek VL, Chen WT, Kluger J, Coleman CI. Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis. BMC Fam Pract 2012;3:13-15.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
Sayıdaki Diğer Makaleler

Şiddetli gestasyonel trombositopeninin başarılı yönetimi: Nadir bir vaka sunumu

ADNAN İNCEBIYIK, Mehmet VURAL, Aysun CAMUZCUOĞLU, NEŞE GÜL HİLALİ, Fatih KURNAZ, Hakan CAMUZCUOĞLU

Yoğun bakım biriminde izlenen çoklu travma hastalarında mortaliteye etki eden faktörler

Ali DUR, Sedat KOÇAK, Başar CANDER, Ertan SÖNMEZ, Cemil CİVELEK

Çeşitli kronik karaciğer hastalığı vakalarında T lenfosit subtiplerinin dağılımı

Fulya İLHAN, SEVGİ KALKANLI TAŞ, HÜSEYİN ATASEVEN, Nalan MİRZAİ, İ. Halil BAHÇECİOĞLU

Paraoksonaz enzim aktivitesi ölçümünde manuel yöntemin standardizasyonu ve performans değerlendirmesi

Gökhan ÇAKIRCA, Osman EELİYAOĞLU, CEMAL POLAT, Fatma Birgül IŞIK, NURİYE METE

Prenatal testis torsiyonunun ultrasonografik özellikleri: Olgu sunumu

ELİF AĞAÇAYAK, Bahattin AYDOĞDU

Cinsel obsesyonlarla seyreden obsesif-kompulsif bozukluklarda çocukluk çağı travması, cinsel işlevler, psikiyatrik komorbidite ve sosyodemografik veriler

Abdullah AKPINAR, Bahadır BAKIM, Gökay ALPAK, Mehmet ÇEVİK, Burcu Göksan YAVUZ, Oğuz KARAMUSTAFALIOĞLU

Epidemiological approach to the atrial fibrillation patients

Faruk ERTAŞ

Üçüncü basamak bir hastanedeki gastroenteritli çocuklarda Rotavirüs enfeksiyonu sıklığı

MUSTAFA ALTAY ATALAY, İdris KANDEMİR, SELMA GÖKAHMETOĞLU

Doksisikline bağli özefagus hasarları: Olgu serisi

İsmail DEMİRYILMAZ, İsmayil YILMAZ, Kemal PEKER, Atalay ŞAHİN, Nurdan SEKBAN

Olgu sunumu: Werner sendromu

FARUK KILINÇ, Alpaslan Kemal TUZCU, Coşkun BEYAZ, ŞADİYE ALTUN TUZCU