Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

Topçuoğlu, Mehmet Akif; Arsava, Ethem Murat; Özdemir, Atilla Özcan; Aykaç, Özlem; Çetiner, Mustafa; Sarıönder Gencer, Elif; Güneş, Aygül; Krespi, Yakup; Yaka, Erdem; Öcek, Levent; Tanrıverdi, Zeynep; Yalaz Tekan, Ülgen; Özkul, Ayça; Özkan, Esra; Şirin, Hadiye; Güler, Ayşe; Kurşun, Oğuzhan; Kunt, Refik; Cenikli, Utku; Acar, Bilgehan; Kablan, Yüksel; Yılmaz, Ayşe; Işıkay, Canan Togay; Aslanbaba, Eda; Sorgun, Mine; Bektaş, Hesna; Çabalar, Murat; Yayla, Vildan; Erdoğan, Hacı Ali; Gökçe, Mustafa; Bavli, Songül; Ongun, Nedim; Keskin, Ahmet Onur; Akdoğan, Özlem; Emre, Ufuk; Kayım Yıldız, Özlem; Bolayır, Aslı; Akpınar, Çetin Kürşad; Karadeli, Hasan Hüseyin; Özel, Tuğba; Ünal, Ali; Dora, Babür; Arlıer, Zülfikar; Eren, Alper; Milanoğlu, Aysel; Nazliel, Bijen; Batur Çağlayan, Hale; Güven, Bülent; Erdoğan, Mücahid; Özdemir Acar, Zeynep; Bakar, Mustafa; Giray, Semih; Şenadım, Songül; Asil, Talip; Demir, Turgay; Özüm Ünsal, Yaprak; Eşkut, Neslihan; Baştan, Birgül; Acar, Zeynep; Niflioğlu, Buket; Yazıcı, Duran; Aytaç, Emrah; İnce, Fatma Birsen; Ay, Halil; Önder, Halil; Kozak, Hasan Hüseyin; İlgezdi, İrem; Bilgiç, Adnan Burak; Akyol, Şenol; Güngör, Levent; Atmaca, Murat Mert; Şen, Mustafa; Yevgi, Recep; Yazıcı Akkaş, Sinem; Yoldaş, Tahir; Atasoy, H. Tuğrul; Çınar, Bilge Piri; Yılmaz, Arda; Genç, Hamit; Kısabay, Ayşın; İlik, Faik; Demirbaş, Hayri; Midi, İpek; Bekdik Şirinocak, Pınar; Duman, Taşkın; Demir, Tülin; Can, Ufuk; Yürekli, Vedat Ali; Bozdoğan, Zehra; Alioğlu, Zekeriya; Kaya, Dilaver; Afşar, Nazire; Gürkaş, Erdem; Toplutaş, Eren; Değirmenci, Eylem; Büyükşerbetçi, Gülseren; Aydın, İsa; Epçeliden, M. Tuncay; Turgut, Nilda; Kale, Nilüfer; Çoban, Eda; Yeşilot, Nilüfer; Ekizoğlu, Esme; Kizek, Özgü; Bilgili, Özlem; Baydemir, Recep; Akçakoyunlu, Merve; Yılmaz, Zahide; Öztürk, Şerefnur

doi:10.4274/tnd.2023.99492

Makale Tam Makale Uluslararası 2023

Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study

Mehmet Akif Topçuoğlu, Ethem Murat Arsava, Atilla Özcan Özdemir, Özlem Aykaç, Mustafa Çetiner, Elif Sarıönder Gencer, Aygül Güneş, Yakup Krespi, Erdem Yaka, Levent Öcek, Zeynep Tanrıverdi, Ülgen Yalaz Tekan, Ayça Özkul, Esra Özkan, Hadiye Şirin, Ayşe Güler, Oğuzhan Kurşun, Refik Kunt, Utku Cenikli, Bilgehan Acar, Yüksel Kablan, Ayşe Yılmaz, Canan Togay Işıkay, Eda Aslanbaba, Mine Sorgun, Hesna Bektaş, Murat Çabalar, Vildan Yayla, Hacı Ali Erdoğan, Mustafa Gökçe, Songül Bavli, Nedim Ongun, Ahmet Onur Keskin, Özlem Akdoğan, Ufuk Emre, Özlem Kayım Yıldız, Aslı Bolayır, Çetin Kürşad Akpınar, Hasan Hüseyin Karadeli, Tuğba Özel, Ali Ünal, Babür Dora, Zülfikar Arlıer, Alper Eren, Aysel Milanoğlu, Bijen Nazliel, Hale Batur Çağlayan, Bülent Güven, Mücahid Erdoğan, Zeynep Özdemir Acar, Mustafa Bakar, Semih Giray, Songül Şenadım, Talip Asil, Turgay Demir, Yaprak Özüm Ünsal, Neslihan Eşkut, Birgül Baştan, Zeynep Acar, Buket Niflioğlu, Duran Yazıcı, Emrah Aytaç, Fatma Birsen İnce, Halil Ay, Halil Önder, Hasan Hüseyin Kozak, İrem İlgezdi, Adnan Burak Bilgiç, Şenol Akyol, Levent Güngör, Murat Mert Atmaca, Mustafa Şen, Recep Yevgi, Sinem Yazıcı Akkaş, Tahir Yoldaş, H. Tuğrul Atasoy, Bilge Piri Çınar, Arda Yılmaz, Hamit Genç, Ayşın Kısabay, Faik İlik, Hayri Demirbaş, İpek Midi, Pınar Bekdik Şirinocak, Taşkın Duman, Tülin Demir, Ufuk Can, Vedat Ali Yürekli, Zehra Bozdoğan, Zekeriya Alioğlu, Dilaver Kaya, Nazire Afşar, Erdem Gürkaş, Eren Toplutaş, Eylem Değirmenci, Gülseren Büyükşerbetçi, İsa Aydın, M. Tuncay Epçeliden, Nilda Turgut, Nilüfer Kale, Eda Çoban, Nilüfer Yeşilot, Esme Ekizoğlu, Özgü Kizek, Özlem Bilgili, Recep Baydemir, Merve Akçakoyunlu, Zahide Yılmaz, Şerefnur Öztürk

TURKISH JOURNAL OF NEUROLOGY Cilt 29 · Sayı 3 · ss. 183–189 · 01.10.2023

DOI ile aç

Özet

Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in our country. Within the scope of NeuroTek-Turkey, hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute stroke algorithms.<br style="color: rgb(81, 81, 81); font-family: Roboto, Geneva, sans-serif;">Materials and Methods: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Türkiye. Within the scope of NöroTek-Türkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms.<br style="color: rgb(81, 81, 81); font-family: Roboto, Geneva, sans-serif;">Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received “effective” treatment [international normalization ratio ≥2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug.<br style="color: rgb(81, 81, 81); font-family: Roboto, Geneva, sans-serif;">Conclusion: NöroTekTR revealed the high but expected frequency of AF in acute stroke in Türkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Türkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known AF. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by AF.

Anahtar kelimeler

relapse anticoagulant Acute stroke transient ischemic attack therapeutic dose Holter monitoring

Atıf için künye

Topçuoğlu, M. A., Arsava, E. M., Özdemir, A. Ö., Aykaç, Ö., Çetiner, M., Sarıönder Gencer, E., Güneş, A., Krespi, Y., Yaka, E., Öcek, L., Tanrıverdi, Z., Yalaz Tekan, Ü., Özkul, A., Özkan, E., Şirin, H., Güler, A., Kurşun, O., Kunt, R., Cenikli, U., … Öztürk, Ş. (2023). Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study. TURKISH JOURNAL OF NEUROLOGY, 29(3), 183–189. https://doi.org/10.4274/tnd.2023.99492

BibTeX

@article{topcuoglu2023-243065,
  author = {Topçuoğlu, Mehmet Akif and Arsava, Ethem Murat and Özdemir, Atilla Özcan and Aykaç, Özlem and Çetiner, Mustafa and Sarıönder Gencer, Elif and Güneş, Aygül and Krespi, Yakup and Yaka, Erdem and Öcek, Levent and Tanrıverdi, Zeynep and Yalaz Tekan, Ülgen and Özkul, Ayça and Özkan, Esra and Şirin, Hadiye and Güler, Ayşe and Kurşun, Oğuzhan and Kunt, Refik and Cenikli, Utku and Acar, Bilgehan and Kablan, Yüksel and Yılmaz, Ayşe and Işıkay, Canan Togay and Aslanbaba, Eda and Sorgun, Mine and Bektaş, Hesna and Çabalar, Murat and Yayla, Vildan and Erdoğan, Hacı Ali and Gökçe, Mustafa and Bavli, Songül and Ongun, Nedim and Keskin, Ahmet Onur and Akdoğan, Özlem and Emre, Ufuk and Kayım Yıldız, Özlem and Bolayır, Aslı and Akpınar, Çetin Kürşad and Karadeli, Hasan Hüseyin and Özel, Tuğba and Ünal, Ali and Dora, Babür and Arlıer, Zülfikar and Eren, Alper and Milanoğlu, Aysel and Nazliel, Bijen and Batur Çağlayan, Hale and Güven, Bülent and Erdoğan, Mücahid and Özdemir Acar, Zeynep and Bakar, Mustafa and Giray, Semih and Şenadım, Songül and Asil, Talip and Demir, Turgay and Özüm Ünsal, Yaprak and Eşkut, Neslihan and Baştan, Birgül and Acar, Zeynep and Niflioğlu, Buket and Yazıcı, Duran and Aytaç, Emrah and İnce, Fatma Birsen and Ay, Halil and Önder, Halil and Kozak, Hasan Hüseyin and İlgezdi, İrem and Bilgiç, Adnan Burak and Akyol, Şenol and Güngör, Levent and Atmaca, Murat Mert and Şen, Mustafa and Yevgi, Recep and Yazıcı Akkaş, Sinem and Yoldaş, Tahir and Atasoy, H. Tuğrul and Çınar, Bilge Piri and Yılmaz, Arda and Genç, Hamit and Kısabay, Ayşın and İlik, Faik and Demirbaş, Hayri and Midi, İpek and Bekdik Şirinocak, Pınar and Duman, Taşkın and Demir, Tülin and Can, Ufuk and Yürekli, Vedat Ali and Bozdoğan, Zehra and Alioğlu, Zekeriya and Kaya, Dilaver and Afşar, Nazire and Gürkaş, Erdem and Toplutaş, Eren and Değirmenci, Eylem and Büyükşerbetçi, Gülseren and Aydın, İsa and Epçeliden, M. Tuncay and Turgut, Nilda and Kale, Nilüfer and Çoban, Eda and Yeşilot, Nilüfer and Ekizoğlu, Esme and Kizek, Özgü and Bilgili, Özlem and Baydemir, Recep and Akçakoyunlu, Merve and Yılmaz, Zahide and Öztürk, Şerefnur},
  title = {Atrial Fibrillation Management in Acute Stroke Patients in Türkiye: Real-life Data from the NöroTek Study},
  journal = {TURKISH JOURNAL OF NEUROLOGY},
  year = {2023},
  volume = {29},
  number = {3},
  pages = {183--189},
  issn = {1301-062X},
  doi = {10.4274/tnd.2023.99492},
  url = {https://akademik.atauni.edu.tr/yayinlar/243065-atrial-fibrillation-management-in-acute-stroke-patients-in-turkiye-real-life}
}