ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Real-World Data on the Incidence of Stroke, Myocardial Infarction, and Mortality Among Nonvalvular Atrial Fibrillation Patients in Türkiye: New Oral Anticoagulants-TURKey Study [Anatol J Cardiol]
Anatol J Cardiol. 2024; 28(1): 19-28 | DOI: 10.14744/AnatolJCardiol.2023.3389

Real-World Data on the Incidence of Stroke, Myocardial Infarction, and Mortality Among Nonvalvular Atrial Fibrillation Patients in Türkiye: New Oral Anticoagulants-TURKey Study

Serkan Ünlü1, Servet Altay2, Ömer Gedikli3, Özge Özden4, Uğur Canpolat5, Lütfü Aşkın6, Çağrı Yayla7, Ahmet Yanık8, Hüseyin Altuğ Çakmak9, Ümit Yaşar Sinan10, Feyzullah Beşli11, Mahmut Şahin3, Seçkin Pehlivanoğlu12
1Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Türkiye
2Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Türkiye
3Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye
4Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
5Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye
6Department of Cardiology, Faculty of Medicine, Adıyaman University, Adıyaman, Türkiye
7Department of Cardiology, Yüksek İhtisas Training and Research Hospital, Ankara, Türkiye
8Department of Cardiology, Samsun Training and Research Hospital, Samsun, Türkiye
9Department of Cardiology, Mustafa Kemal Paşa State Hospital, Bursa, Türkiye
10Institute of Cardiology, Faculty of Medicine, İstanbul University, İstanbul, Türkiye
11Department of Cardiology, Faculty of Medicine, Harran University, Şanlıurfa, Türkiye
12Department of Cardiology, Faculty of Medicine, Başkent University, İstanbul, Türkiye

Background: Atrial fibrillation (AF) is strongly associated with an increased risk of ischemic events. Anticoagulation focuses on reducing the risk of embolism. Guideline recommended CHA2DS2-VASc scoring system is most widely used; however, different scoring systems do exist. Thus, we sought to assess the impact of anticoagulant treatment and different scoring systems on the development of stroke, myocardial infarction, and all-cause mortality in patients with nonvalvular AF.

Methods: The present study was designed as a prospective cohort study. The enrollment of the patients was conducted between August 1, 2015, and January 1, 2016. The follow-up period was defined as the time from enrollment to the end of April 1, 2017, which also provided at least 12 months of prospective follow-up for each patient.

Results: A total of 1807 patients with AF were enrolled. During the follow-up, 2.7% (48) of patients had stroke, 0.8% (14) had myocardial infarction, and 7.5% (136) died. The anticoagulation and risk factors in AF (ATRIA) score had a better accuracy for the prediction of stroke compared to other scoring systems (0.729, 95% CI, 0.708-0.750, P <.05). Patients under low-dose rivaroxaban treatment had significantly worse survival (logrank P <.001). Age, CHA2DS2-VASc score, R2CHADS2 score, ATRIA score, chronic heart failure, prior stroke, and being under low-dose rivaroxaban treatment were independent predictors of clinical endpoint (P <.001).

Conclusion: Low-dose rivaroxaban treatment was independently and strongly associated with the combined clinical endpoint. Furthermore, the ATRIA score proved to be a stronger predictor of stroke in the Turkish population.

Keywords: Anticoagulant agents, atrial fibrillation, death, ischemic stroke, myocardial infarction

Serkan Ünlü, Servet Altay, Ömer Gedikli, Özge Özden, Uğur Canpolat, Lütfü Aşkın, Çağrı Yayla, Ahmet Yanık, Hüseyin Altuğ Çakmak, Ümit Yaşar Sinan, Feyzullah Beşli, Mahmut Şahin, Seçkin Pehlivanoğlu. Real-World Data on the Incidence of Stroke, Myocardial Infarction, and Mortality Among Nonvalvular Atrial Fibrillation Patients in Türkiye: New Oral Anticoagulants-TURKey Study. Anatol J Cardiol. 2024; 28(1): 19-28

Corresponding Author: Serkan Ünlü, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

Quick Search



Copyright © 2024 The Anatolian Journal of Cardiology



Kare Publishing is a subsidiary of Kare Media.