title: New oral anticoagulants-TURKey (NOAC-TURK): Multicenter cross-sectional study.
abstract: OBJECTIVE
  New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed.
  
  
  METHODS
  The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study. A total of 2,862 patients from 21 different centers of Turkey under the treatment of NOACs for at least three months were included in this study. Demographic, clinical, and laboratory characteristics of study participants with their medications used were obtained through the NOAC-TURK survey database. Additional necessary medical records were obtained from electronic health records of participating centers.
  
  
  RESULTS
  Of the 2. 862 patients, 1.131 (39.5%) were male and the mean age was 70.3±10.2 years. Hypertension was found as the most frequent comorbidity (81%). The most common indication for NOACs was permanent atrial fibrillation (83.3%). NOACs were mainly preferred because of inadequate therapeutic range or overdose during warfarin usage. The most frequent complication was bleeding (n=217, 7.6%), and major bleeding was observed in 1.1% of the patients. Embolic events were observed in 37 patients (1.3%). Rivaroxaban and dabigatran were both more preferred than apixaban. Almost half of the patients (47.6%) were using lower doses of NOACs, which is definitely much more than expected.
  
  
  CONCLUSIONS
  The NOAC-TURK study showed an important overview of the current NOACs treatment regimens in Turkey. Although embolic and bleeding complications were lower than or similar to previous studies, increased utilization of low-dose NOACs in this study should be considered carefully. According to the results of this study, NOACs treatment should be guided through CHA2DS2-VASc and HASBLED scores to ensure more benefit and less adverse effects in NVAF patients.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Trakya University; Edirne-Turkey. svtaltay@gmail.com.
authors.forename: Servet
authors.initials: S
authors.lastname: Altay
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Yıldırımtürk
authors.forename: Hüseyin Altuğ
authors.initials: HA
authors.lastname: Çakmak
authors.forename: Lütfü
authors.initials: L
authors.lastname: Aşkın
authors.forename: Ümit Yaşar
authors.initials: ÜY
authors.lastname: Sinan
authors.forename: Feyzullah
authors.initials: F
authors.lastname: Beşli
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Gedikli
authors.forename: Özge
authors.initials: Ö
authors.lastname: Özden Tok
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000600:supply & distribution*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D018570:Risk Assessment; D014421:Turkey / Q000453:epidemiology
chemical_list: D000925:Anticoagulants