Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice

Oleg V. Gaisenok; Anton S. Leonov

doi:doi:10.11648/j.ccr.20170102.11

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Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice

Oleg V. Gaisenok, Anton S. Leonov

Published in Cardiology and Cardiovascular Research (Volume 1, Issue 2)

Received: 25 February 2017 Accepted: 23 March 2017 Published: 14 April 2017

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Abstract

Objective: To analyze the assignability of anticoagulation in patients with atrial fibrillation (including new oral anticoagulants (NOAC)) and detection of paroxysmal supraventricular tachycardia (SVT), according to a cohort study conducted on the rules of the local registry. Methods: Patients with atrial fibrillation, selected from 526 patients treated in the department in 2013, accounted study group (n = 58). Analysis of prescribed therapy, the percentage of anticoagulant therapy (including the new oral anticoagulants), detection of SVT held on all enrolled patients. Results: use of anticoagulants in the study group was 46.5% (NOAC - 20.7%). The main reason fails to appoint anticoagulant therapy were follows: the inability of the patient to adhere or to monitor warfarin therapy and the presence of valvular AF, which does not allow to recommend NOAC (48.4%) and physician preference, based on the refusal or the patient's preference (41.9%). The presence of valvular AF significantly limited the possibility of appointing the NOAC. SVT has been registered by Holter ECG during hospitalization in 24 patients with AF. Moreover 12 patients without AF were previously identified SVT. Conclusions: The appointment of anticoagulants in patients with AF is insufficient. More active use of NOAC will allow to correct current situation. The correct interpretation of the concept of valvular AF can help it. Considering that under the mask of paroxysmal SVT described by Holter ECG may be hiding paroxysmal AF, open to debate is the question of the appointment of anticoagulant therapy in these patients. Answer this question will be able to conduct of specially-designed randomized clinical trials.

Published in	Cardiology and Cardiovascular Research (Volume 1, Issue 2)
DOI	10.11648/j.ccr.20170102.11
Page(s)	29-31
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Atrial Fibrillation, New Oral Anticoagulants, Reasons for Not Prescribing Anticoagulants, Paroxysmal Supraventricular Tachycardia

References

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[2]	Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 9; 285 (18): 2370-5. PMID: 11343485.
[3]	Miyasaka Y, Barnes ME, Gersh BJ, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006 Jul 11; 114 (2): 119-25. Epub 2006 Jul 3.. Erratum in: Circulation 2006; 114: e498. PMID: 16818816 DOI: 10.1161/CIRCULATIONAHA.105.595140.
[4]	Savelieva I, Camm J. Update on atrial fibrillation: part I. Clin Cardiol. 2008 Feb; 31 (2): 55-62. doi: 10.1002/clc.20138. PMID: 18257025.
[5]	Gaisenok OV, Leonov AS. Influence of rate- and rhythm-control therapy on the frequency of hospitalizations in patients with atrial fibrillation. Vrach 2015; 3: 59-62. (In Russ.).
[6]	Gaisenok OV, Leonov AS. The use of oral anticoagulants in patients with atrial fibrillation: cohort study data. Rational Pharmacotherapy in Cardiology. 2016; 12 (4): 376-379. (In Russ.) DOI: 10.20996/1819-6446-2016-12-4-376-379.
[7]	O'Brien EC, Simon DN, Allen LA, et al. Reasons for Warfarin Discontinuation in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Am Heart J. 2014 Oct; 168 (4): 487-94. doi: 10.1016/j.ahj.2014.07.002. Epub 2014 Jul 11. PMID: 25262258.
[8]	De Caterina R, Hylek EM. Stroke prevention in atrial fibrillation: current status and near-future directions. Am J Med. 2011 Sep; 124 (9): 793-9. doi: 10.1016/j.amjmed.2011.03.013. PMID: 21745652.
[9]	Lip GY, Agnelli G, Thach AA, et al. Oral anticoagulation in atrial fibrillation: A pan-European patient survey. Eur J Intern Med. 2007 May; 18 (3): 202-8. PMID: 17449392.
[10]	Baturova MA. Atrial fibrillation in patients with ischemic stroke. Journal of Arrhythmology 2014; 76: 51-56 (In Russ.).
[11]	Binici Z, Intzilakis T, Nielsen OW, et al. Excessive supraventricular ectopic activity and increased risk of atrial fibrillation and stroke. Circulation. 2010 May 4; 121 (17): 1904-11. doi: 10.1161/CIRCULATIONAHA.109.874982. PMID: 20404258.
[12]	Connolly S. J., Ezekowitz M. D., Yusuf S. et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009 Sep 17; 361 (12): 1139-51. doi: 10.1056/NEJMoa0905561. Epub 2009 Aug 30. PMID: 19717844.
[13]	Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation. N Engl J Med. 2011 Sep 8; 365 (10): 883-91. doi: 10.1056/NEJMoa1009638. Epub 2011 Aug 10. PMID: 21830957.
[14]	Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2011 Sep 15; 365 (11): 981-92. doi: 10.1056/NEJMoa1107039. Epub 2011 Aug 27. PMID: 21870978.
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APA Style

Oleg V. Gaisenok, Anton S. Leonov. (2017). Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice. Cardiology and Cardiovascular Research, 1(2), 29-31. https://doi.org/10.11648/j.ccr.20170102.11

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ACS Style

Oleg V. Gaisenok; Anton S. Leonov. Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice. Cardiol. Cardiovasc. Res. 2017, 1(2), 29-31. doi: 10.11648/j.ccr.20170102.11

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AMA Style

Oleg V. Gaisenok, Anton S. Leonov. Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice. Cardiol Cardiovasc Res. 2017;1(2):29-31. doi: 10.11648/j.ccr.20170102.11

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@article{10.11648/j.ccr.20170102.11,
  author = {Oleg V. Gaisenok and Anton S. Leonov},
  title = {Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice},
  journal = {Cardiology and Cardiovascular Research},
  volume = {1},
  number = {2},
  pages = {29-31},
  doi = {10.11648/j.ccr.20170102.11},
  url = {https://doi.org/10.11648/j.ccr.20170102.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20170102.11},
  abstract = {Objective: To analyze the assignability of anticoagulation in patients with atrial fibrillation (including new oral anticoagulants (NOAC)) and detection of paroxysmal supraventricular tachycardia (SVT), according to a cohort study conducted on the rules of the local registry. Methods: Patients with atrial fibrillation, selected from 526 patients treated in the department in 2013, accounted study group (n = 58). Analysis of prescribed therapy, the percentage of anticoagulant therapy (including the new oral anticoagulants), detection of SVT held on all enrolled patients. Results: use of anticoagulants in the study group was 46.5% (NOAC - 20.7%). The main reason fails to appoint anticoagulant therapy were follows: the inability of the patient to adhere or to monitor warfarin therapy and the presence of valvular AF, which does not allow to recommend NOAC (48.4%) and physician preference, based on the refusal or the patient's preference (41.9%). The presence of valvular AF significantly limited the possibility of appointing the NOAC. SVT has been registered by Holter ECG during hospitalization in 24 patients with AF. Moreover 12 patients without AF were previously identified SVT. Conclusions: The appointment of anticoagulants in patients with AF is insufficient. More active use of NOAC will allow to correct current situation. The correct interpretation of the concept of valvular AF can help it. Considering that under the mask of paroxysmal SVT described by Holter ECG may be hiding paroxysmal AF, open to debate is the question of the appointment of anticoagulant therapy in these patients. Answer this question will be able to conduct of specially-designed randomized clinical trials.},
 year = {2017}
}

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TY - JOUR
T1 - Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice
AU - Oleg V. Gaisenok
AU - Anton S. Leonov
Y1 - 2017/04/14
PY - 2017
N1 - https://doi.org/10.11648/j.ccr.20170102.11
DO - 10.11648/j.ccr.20170102.11
T2 - Cardiology and Cardiovascular Research
JF - Cardiology and Cardiovascular Research
JO - Cardiology and Cardiovascular Research
SP - 29
EP - 31
PB - Science Publishing Group
SN - 2578-8914
UR - https://doi.org/10.11648/j.ccr.20170102.11
AB - Objective: To analyze the assignability of anticoagulation in patients with atrial fibrillation (including new oral anticoagulants (NOAC)) and detection of paroxysmal supraventricular tachycardia (SVT), according to a cohort study conducted on the rules of the local registry. Methods: Patients with atrial fibrillation, selected from 526 patients treated in the department in 2013, accounted study group (n = 58). Analysis of prescribed therapy, the percentage of anticoagulant therapy (including the new oral anticoagulants), detection of SVT held on all enrolled patients. Results: use of anticoagulants in the study group was 46.5% (NOAC - 20.7%). The main reason fails to appoint anticoagulant therapy were follows: the inability of the patient to adhere or to monitor warfarin therapy and the presence of valvular AF, which does not allow to recommend NOAC (48.4%) and physician preference, based on the refusal or the patient's preference (41.9%). The presence of valvular AF significantly limited the possibility of appointing the NOAC. SVT has been registered by Holter ECG during hospitalization in 24 patients with AF. Moreover 12 patients without AF were previously identified SVT. Conclusions: The appointment of anticoagulants in patients with AF is insufficient. More active use of NOAC will allow to correct current situation. The correct interpretation of the concept of valvular AF can help it. Considering that under the mask of paroxysmal SVT described by Holter ECG may be hiding paroxysmal AF, open to debate is the question of the appointment of anticoagulant therapy in these patients. Answer this question will be able to conduct of specially-designed randomized clinical trials.
VL - 1
IS - 2
ER -

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Author Information

Oleg V. Gaisenok

Department of Cardiology and Internal Diseases, FSI "United Hospital with Outpatient Department", Moscow, Russian Federation
Anton S. Leonov

Department of Cardiology and Internal Diseases, FSI "United Hospital with Outpatient Department", Moscow, Russian Federation

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APA Style

Oleg V. Gaisenok, Anton S. Leonov. (2017). Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice. Cardiology and Cardiovascular Research, 1(2), 29-31. https://doi.org/10.11648/j.ccr.20170102.11

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ACS Style

Oleg V. Gaisenok; Anton S. Leonov. Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice. Cardiol. Cardiovasc. Res. 2017, 1(2), 29-31. doi: 10.11648/j.ccr.20170102.11

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AMA Style

Oleg V. Gaisenok, Anton S. Leonov. Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice. Cardiol Cardiovasc Res. 2017;1(2):29-31. doi: 10.11648/j.ccr.20170102.11

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@article{10.11648/j.ccr.20170102.11,
  author = {Oleg V. Gaisenok and Anton S. Leonov},
  title = {Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice},
  journal = {Cardiology and Cardiovascular Research},
  volume = {1},
  number = {2},
  pages = {29-31},
  doi = {10.11648/j.ccr.20170102.11},
  url = {https://doi.org/10.11648/j.ccr.20170102.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20170102.11},
  abstract = {Objective: To analyze the assignability of anticoagulation in patients with atrial fibrillation (including new oral anticoagulants (NOAC)) and detection of paroxysmal supraventricular tachycardia (SVT), according to a cohort study conducted on the rules of the local registry. Methods: Patients with atrial fibrillation, selected from 526 patients treated in the department in 2013, accounted study group (n = 58). Analysis of prescribed therapy, the percentage of anticoagulant therapy (including the new oral anticoagulants), detection of SVT held on all enrolled patients. Results: use of anticoagulants in the study group was 46.5% (NOAC - 20.7%). The main reason fails to appoint anticoagulant therapy were follows: the inability of the patient to adhere or to monitor warfarin therapy and the presence of valvular AF, which does not allow to recommend NOAC (48.4%) and physician preference, based on the refusal or the patient's preference (41.9%). The presence of valvular AF significantly limited the possibility of appointing the NOAC. SVT has been registered by Holter ECG during hospitalization in 24 patients with AF. Moreover 12 patients without AF were previously identified SVT. Conclusions: The appointment of anticoagulants in patients with AF is insufficient. More active use of NOAC will allow to correct current situation. The correct interpretation of the concept of valvular AF can help it. Considering that under the mask of paroxysmal SVT described by Holter ECG may be hiding paroxysmal AF, open to debate is the question of the appointment of anticoagulant therapy in these patients. Answer this question will be able to conduct of specially-designed randomized clinical trials.},
 year = {2017}
}

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