2Department of Cardiology, Şanlıurfa Balıklıgöl State Hospital; Şanlıurfa- Turkey
3Department of Cardiology, Siyami Ersek Heart Education and Research Hospital; İstanbul- Turkey
4Department of Cardiology, Tuzla State Hospital; İstanbul-Turkey
5Department of Cardiology, Bandırma State Hospital; Balıkesir-Turkey
6Department of Cardiology, Yozgat State Hospital; Yozgat-Turkey
7Department of Cardiology, Gaziemir State Hospital; İzmir-Turkey
8Department of Cardiology, Ankara Keçiören Education and Research Hospital; Ankara-Turkey
9Department of Cardiology, Şişli Hamidiye Etfal Education and Research Hospital; İstanbul- Turkey
10Department of Cardiology, Mersin Private Doğuş Hospital; Mersin-Turkey
11Department of Cardiology, Mersin Toros State Hospital; Mersin-Turkey
12Department of Cardiology, Gaziantep 25 Aralık State Hospital; Gaziantep-Turkey
13Department of Cardiology, Kocaeli Derince Education and Research Hospital; Kocaeli- Turkey
14Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital; İstanbul-Turkey
Abstract
Objective: This study aimed to determine the differences in terms of demographic characteristics and preferred stroke prevention strategies for patients with non-valvular atrial fibrillation living in seven geographical regions of Turkey.
Methods: In total, 6273 patients were enrolled to this prospective, observational RAMSES study. The patients were divided into seven groups based on the geographical region of residence.
Results: In terms of the geographical distribution of the overall Turkish population, the highest number of patients were enrolled from Marmara (1677, 26.7%). All demographic characteristics were significantly different among regions. Preferred oral anticoagulants (OACs) also differed between geographical regions; non-vitamin K OACs were preceded by warfarin in East Anatolia, Aegean, Southeast Anatolia, and Black Sea. Nearly one-third of the patients (28%) did not receive any OAC therapy. However, the number of patients not receiving any OAC therapy was higher in Southeast Anatolia (51.1%) and East Anatolia (46.8%) compared with other geographical regions of Turkey. Inappropriate use of OACs was also more common in East and Southeast Anatolia.
Conclusion: This study was the first to show that the demographic differences among the geographical regions may result in different preferences of stroke prevention strategies in Turkey. OACs are still under- or inappropriately utilized, particularly in the eastern provinces of Turkey.