title: Stroke prevention in atrial fibrillation and 'real world' adherence to guidelines in the Balkan Region: The BALKAN-AF Survey.
abstract: Data on the management of atrial fibrillation (AF) in the Balkan Region are limited. The Serbian AF Association (SAFA) prospectively investigated contemporary 'real-world' AF management in clinical practice in Albania, Bosnia&Herzegovina, Bulgaria, Croatia, Montenegro, Romania and Serbia through a 14-week (December 2014-February 2015) prospective, multicentre survey of consecutive AF patients. We report the results pertinent to stroke prevention strategies. Of 2712 enrolled patients, 2663 (98.2%) with complete data were included in this analysis (mean age 69.1 ± 10.9 years, female 44.6%). Overall, 1960 patients (73.6%) received oral anticoagulants (OAC) and 762 (28.6%) received antiplatelet drugs. Of patients given OAC, 17.2% received non-vitamin K antagonist oral anticoagulants (NOACs). CHA2DS2-VASc score was not significantly associated with OAC use. Of the 'truly low-risk' patients (CHA2DS2-VASc = 0 [males], or 1 [females]) 56.5% received OAC. Time in Therapeutic Range (TTR) was available in only 18.7% of patients (mean TTR: 49.5% ± 22.3%). Age ≥ 80 years, prior myocardial infarction and paroxysmal AF were independent predictors of OAC non-use. Our survey shows a relatively high overall use of OAC in AF patients, but with low quality of vitamin K antagonist therapy and insufficient adherence to AF guidelines. Additional efforts are needed to improve AF-related thromboprophylaxis in clinical practice in the Balkan Region.
authors: School of Medicine, Belgrade University, Belgrade, Serbia.|Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Tatjana S
authors: TS
authors: Potpara
authors: Medicine University "Carol Davila", Colentina University Hospital, Bucharest, Romania.
authors: Gheorghe-Andrei
authors: GA
authors: Dan
authors: National Heart Hospital, Sofia, Bulgaria.
authors: Elina
authors: E
authors: Trendafilova
authors: Clinic of Cardiology, University Hospital centre Mother Theresa, Tirana, Albania.
authors: Artan
authors: A
authors: Goda
authors: Cardiology Department, Clinic for internal diseases, Tuzla, Bosnia &Herzegovina.
authors: Zumreta
authors: Z
authors: Kusljugic
authors: Clinical Hospital Centre Sestre Milosrdnice, Zagreb, Croatia.
authors: Sime
authors: S
authors: Manola
authors: University Clinical Centre Podgorica, Podgorica, Montenegro.
authors: Ljilja
authors: L
authors: Music
authors: Cardiology Centre, County Emergency Hospital, Craiova, Romania.
authors: Rodica
authors: R
authors: Musetescu
authors: Medicine University "Carol Davila", Emergency Clinical Hospital, Internal Medicine Department, Bucharest, Romania.
authors: Elisabeta
authors: E
authors: Badila
authors: Clinical Centre Vojvodina, Novi Sad, Serbia.
authors: Gorana
authors: G
authors: Mitic
authors: Clinic of Cardiology, University Hospital centre Mother Theresa, Tirana, Albania.
authors: Vilma
authors: V
authors: Paparisto
authors: National Heart Hospital, Sofia, Bulgaria.
authors: Elena S
authors: ES
authors: Dimitrova
authors: School of Medicine, Belgrade University, Belgrade, Serbia.|Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Marija M
authors: MM
authors: Polovina
authors: Multiprofile Hospital for Active Treatment, Bourgas, Bulgaria.
authors: Stanislav L
authors: SL
authors: Petranov
authors: Clinic of Cardiology, University Hospital centre Mother Theresa, Tirana, Albania.
authors: Hortensia
authors: H
authors: Djergo
authors: Cardiology Department, Clinic for internal diseases, Tuzla, Bosnia &Herzegovina.
authors: Daniela
authors: D
authors: Loncar
authors: Cardiology Department, Clinic for internal diseases, Tuzla, Bosnia &Herzegovina.
authors: Amira
authors: A
authors: Bijedic
authors: Clinical Hospital Centre Rijeka, Rijeka, Croatia.
authors: Sandro
authors: S
authors: Brusich
authors: School of Medicine, Belgrade University, Belgrade, Serbia.|University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK.
authors: Gregory Y H
authors: GY
authors: Lip
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D000991:Antithrombins / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D063368:Balkan Peninsula / Q000453:epidemiology; D003710:Demography; D005260:Female; D019983:Guideline Adherence; D006306:Health Surveys; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin