Turk Kardiyol Dern Ars. 2015; 43(2): 169-177 | DOI: 10.5543/tkda.2015.35984

An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER*-2 study design

Faruk Ertas¹, Hasan Kaya¹, Abdulkadir Yildiz¹, Vedat Davutoglu², Abdulkadir Kiris³, Lale Dinc⁴, Habibe Kafes⁵, Anil Avci⁶, Bekir Calapkorur⁷, Gokhan Ertas⁸, Mehmet Gul⁹, Nuray Kahraman Ay¹⁰, Serkan Bulur¹¹, Mine Durukan^12
1Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
²Department of Cardiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
³Department of Cardiology, Karadeniz Technique University Faculty of Medicine, Trabzon, Turkey
⁴Department of Cardiology, Diskapi Training and Research Hospital, Ankara, Turkey
⁵Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
⁶Department of Cardiology, Kosuyolu Training and Research Hospital, İstanbul, Turkey
⁷Department of Cardiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
⁸Dept. of Cardiology, Siyami Ersek Training and Research Hospital, Istanbul, Turkey
⁹Dept. of Cardiology, Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
¹⁰Dept. of Cardiology, Bezmialem Foundation University Faculty of Medicine, Istanbul, Turkey
¹¹Dept. of Cardiology, Medeniyet University Faculty of Medicine, Istanbul, Turkey
¹²Dept. of Cardiology, Mardin State Hospital, Mardin, Turkey

OBJECTIVES
Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients.

STUDY DESIGN
Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization).

RESULTS
First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016.

CONCLUSION
The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.).

Keywords: Anticoagulant agent, atrial fibrillation/epidemiology; drug utilization; electrocardiography; international normalized ratio; warfarin

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