Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey
Abstract Background Atrial fibrillation (AF) often co‐exists with renal function (RF) impairment. We investigated the characteristics and management of AF patients across creatinine clearance strata and potential changes in the use of nonvitamin K oral anticoagulants (NOAC) according to different eq...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-10-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12404 |
| _version_ | 1828825579719229440 |
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| author | Monika Kozieł Stefan Simovic Nikola Pavlovic Milan Nedeljkovic Aleksandar Kocijancic Vilma Paparisto Ljilja Music Elina Trendafilova Anca Rodica Dan Sime Manola Zumreta Kusljugic Gheorghe‐Andrei Dan Gregory Y. H. Lip Tatjana S. Potpara the BALKAN‐AF Investigators |
| author_facet | Monika Kozieł Stefan Simovic Nikola Pavlovic Milan Nedeljkovic Aleksandar Kocijancic Vilma Paparisto Ljilja Music Elina Trendafilova Anca Rodica Dan Sime Manola Zumreta Kusljugic Gheorghe‐Andrei Dan Gregory Y. H. Lip Tatjana S. Potpara the BALKAN‐AF Investigators |
| author_sort | Monika Kozieł |
| collection | DOAJ |
| description | Abstract Background Atrial fibrillation (AF) often co‐exists with renal function (RF) impairment. We investigated the characteristics and management of AF patients across creatinine clearance strata and potential changes in the use of nonvitamin K oral anticoagulants (NOAC) according to different equations for estimation of RF. Methods In this post hoc analysis of the BALKAN‐AF survey, patients were classified according to RF (Cockcroft‐Gault formula) as: preserved/mildly depressed RF (P‐RF) ≥50 mL/min, moderately depressed RF (MD‐RF) 30‐49 mL/min, and severely depressed RF (SD‐RF) <30 mL/min. Results Of 2712 enrolled patients, 2062 (76.0%) had data on RF. Patients with SD‐RF and MD‐RF were older, had higher mean value of European Heart Rhythm Association score, stroke and bleeding risk scores, and more comorbidities than patients with P‐RF (all P < .05). They received oral anticoagulants (OAC), AF catheter ablation, and electrical cardioversion less often than those with P‐RF (all P < .05). Rate control, no OAC, single‐antiplatelet therapy (SAPT) alone, and loop diuretics were more prevalent in patients with SD‐RF and MD‐RF than in subjects with P‐RF (all P < .005). An important change in NOAC therapy could appear in <1% of patients (Modification of Diet in Renal Disease formula) and in <1% of patients (Chronic Kidney Disease Epidemiology Collaboration group formula). Conclusions Patients with SD‐RF and MD‐RF were older, more symptomatic, had higher stroke and bleeding risk and more comorbidities than those with P‐RF. They were less likely to receive OAC and more likely to use rate control strategy, SAPT alone, and no OAC than subjects with P‐RF. |
| first_indexed | 2024-12-12T14:20:44Z |
| format | Article |
| id | doaj.art-6c901c9e4cda4e139b248e183fb1c2a0 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-12T14:20:44Z |
| publishDate | 2020-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-6c901c9e4cda4e139b248e183fb1c2a02022-12-22T00:21:48ZengWileyJournal of Arrhythmia1880-42761883-21482020-10-0136586387310.1002/joa3.12404Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF surveyMonika Kozieł0Stefan Simovic1Nikola Pavlovic2Milan Nedeljkovic3Aleksandar Kocijancic4Vilma Paparisto5Ljilja Music6Elina Trendafilova7Anca Rodica Dan8Sime Manola9Zumreta Kusljugic10Gheorghe‐Andrei Dan11Gregory Y. H. Lip12Tatjana S. Potpara13the BALKAN‐AF InvestigatorsLiverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool UKCardiology Clinic University Clinical Center of Kragujevac Kragujevac SerbiaClinical Center Sestre Milosrdnice Zagreb CroatiaCardiology Clinic Clinical Center of Serbia Belgrade SerbiaCardiology Clinic Clinical Center of Serbia Belgrade SerbiaClinic of Cardiology University Hospital Center Mother Theresa Tirana AlbaniaCardiology Clinic University Clinical Center of MontenegroUniversity of PodgoricaMedical Faculty Podgorica MontenegroCoronary Care Unit National Heart Hospital Sofia BulgariaCardiology Department Colentina University Hospital Bucharest RomaniaClinical Center Sestre Milosrdnice Zagreb CroatiaCardiology Department Clinic of Internal Medicine Medical Faculty University Clinical Center Tuzla Tuzla Bosnia and HerzegovinaMedicine University "Carol Davila"Colentina University Hospital Bucharest RomaniaLiverpool Centre for Cardiovascular Science University of Liverpool and Liverpool Heart & Chest Hospital Liverpool UKCardiology Clinic Clinical Center of Serbia Belgrade SerbiaAbstract Background Atrial fibrillation (AF) often co‐exists with renal function (RF) impairment. We investigated the characteristics and management of AF patients across creatinine clearance strata and potential changes in the use of nonvitamin K oral anticoagulants (NOAC) according to different equations for estimation of RF. Methods In this post hoc analysis of the BALKAN‐AF survey, patients were classified according to RF (Cockcroft‐Gault formula) as: preserved/mildly depressed RF (P‐RF) ≥50 mL/min, moderately depressed RF (MD‐RF) 30‐49 mL/min, and severely depressed RF (SD‐RF) <30 mL/min. Results Of 2712 enrolled patients, 2062 (76.0%) had data on RF. Patients with SD‐RF and MD‐RF were older, had higher mean value of European Heart Rhythm Association score, stroke and bleeding risk scores, and more comorbidities than patients with P‐RF (all P < .05). They received oral anticoagulants (OAC), AF catheter ablation, and electrical cardioversion less often than those with P‐RF (all P < .05). Rate control, no OAC, single‐antiplatelet therapy (SAPT) alone, and loop diuretics were more prevalent in patients with SD‐RF and MD‐RF than in subjects with P‐RF (all P < .005). An important change in NOAC therapy could appear in <1% of patients (Modification of Diet in Renal Disease formula) and in <1% of patients (Chronic Kidney Disease Epidemiology Collaboration group formula). Conclusions Patients with SD‐RF and MD‐RF were older, more symptomatic, had higher stroke and bleeding risk and more comorbidities than those with P‐RF. They were less likely to receive OAC and more likely to use rate control strategy, SAPT alone, and no OAC than subjects with P‐RF.https://doi.org/10.1002/joa3.12404atrial fibrillationBALKAN‐AF surveycreatinine clearanceoral anticoagulant therapyrenal function |
| spellingShingle | Monika Kozieł Stefan Simovic Nikola Pavlovic Milan Nedeljkovic Aleksandar Kocijancic Vilma Paparisto Ljilja Music Elina Trendafilova Anca Rodica Dan Sime Manola Zumreta Kusljugic Gheorghe‐Andrei Dan Gregory Y. H. Lip Tatjana S. Potpara the BALKAN‐AF Investigators Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey Journal of Arrhythmia atrial fibrillation BALKAN‐AF survey creatinine clearance oral anticoagulant therapy renal function |
| title | Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey |
| title_full | Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey |
| title_fullStr | Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey |
| title_full_unstemmed | Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey |
| title_short | Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey |
| title_sort | treatment implications of renal disease in patients with atrial fibrillation the balkan af survey |
| topic | atrial fibrillation BALKAN‐AF survey creatinine clearance oral anticoagulant therapy renal function |
| url | https://doi.org/10.1002/joa3.12404 |
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