Epidemiology of atrial fibrillation-related ischemic stroke and its association with DOAC uptake in Spain: first national population-based study 2005 to 2018

Díaz-Guzmán, Jaime; Freixa-Pamias, Román; García‐Alegría, Javier; Cabeza, Alejandro Isidoro Pérez; Roldán‐Rabadán, Inmaculada; Antolin-Fontes, Beatriz; Rebollo, Pablo; Llorac, Aleix; Genís-Gironés, Mar; Escobar-Cervantes, Carlos

doi:10.1016/j.rec.2021.07.009

Cited by 9 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Before the DOAC use, the adjusted incidence rate (IR) of AF‐related ischaemic stroke steadily increased from 2005 (IR = 2.20 per 100,000 person/year) to 2012 (IR = 2.67). Upon DOAC uptake in AF‐related ischaemic stroke prevention, in Spain, from 2012, the IR remained constant or decreased slightly (IR in 2018 = 2.66) 18 . The DOAC uptake was a significant predictor of the rate of AF‐related ischaemic stroke in patients aged >65 years.…”

Section: Discussionmentioning

confidence: 95%

“…The epidemiology of AF‐related stroke and its association with DOAC uptake in Spain were recently published 18 . Data were obtained from the Registry of Activity of Specialised Healthcare of the Spanish Ministry of Health (RAE‐MDS).…”

Section: Discussionmentioning

confidence: 99%

“…Upon DOAC uptake in AF-related ischaemic stroke prevention, in Spain, from 2012, the IR remained constant or decreased slightly (IR in 2018 = 2.66). 18 The DOAC uptake was a significant predictor of the rate of AFrelated ischaemic stroke in patients aged >65 years. The authors stated that while this association is based on aggregate data and cannot demonstrate causality, their findings suggest that a higher DOAC uptake could improve the health outcomes in patients with AF in Spain.…”

Section: Temporal Trend In Oral Anticoagulation Rate and Elapsed Time...mentioning

confidence: 93%

“…The epidemiology of AF-related stroke and its association with DOAC uptake in Spain were recently published. 18 Data were obtained from the Registry of Activity of Specialised Healthcare of the Spanish Ministry of Health (RAE-MDS). Before the DOAC use, the adjusted incidence rate (IR) of AF-related ischaemic stroke steadily increased from 2005 (IR = 2.20 per 100,000 person/year) to 2012 (IR = 2.67).…”

Section: Temporal Trend In Oral Anticoagulation Rate and Elapsed Time...mentioning

confidence: 99%

See 3 more Smart Citations

The impact of inter‐clinician electronic consultation in patients diagnosed with atrial fibrillation in primary care

Mazón‐Ramos

Cinza‐Sanjurjo

Garcia‐Vega

et al. 2022

Eur J Clin Investigation

View full text Add to dashboard Cite

Background An early diagnosis and early initiation of oral anticoagulants (OAC) are main determinants for outcomes in patients with atrial fibrillation (AF). Inter‐clinician electronic consultations (e‐consultations) program for the general practitioner referrals to cardiologist may improve health care access by reducing the elapsed time for cardiology care. Objective To evaluate the effect of a reduced elapsed time to care after a inter‐clinician e‐consultations program implementation (2013–2019) in comparison with previous in‐person consultation (2010–2012) in the outpatient health care management in a Cardiology Department. Methodology We included 10,488 patients with AF from 1 January 2010, to 31 December 2019. Until 2012, all patients attended an in‐person consultation (2010–2012). In 2013, we instituted an e‐consult program (2013–2019) for all primary care referrals to cardiologists that preceded patient's in‐person consultation when considered. The shared electronic patient dossier (EPD) was available between GP and cardiologist, and any change in therapy advice from cardiologist was directly implemented in this EPD. Results During the e‐consultation period (2013–2019) were referred 6627 patients by GPs to cardiology versus 3861 during the in‐person consultation (2010–2012). The e‐consultation implementation was associated with a reduction in the elapsed time to anticoagulation prescription (177.6 ± 8.9 vs. 22.5 ± 8.1 days, p < .001), and an increase of OAC use (61% [95% IC: 19.6%–102.4%], p < .001). The e‐consult program implementation was associated with a reduction in the 1‐year CV mortality (.48 [95% CI: .30–.75]) and all‐cause mortality (.42 [95% CI: .29–.62]). The OAC reduces the stroke mortality (.15 [95% CI: .06–.39]) and CV mortality (.43 [95% CI: .29–.62]) and all‐cause mortality (.23 [95% CI: .17–.31]). Conclusion A shared EPD‐based inter‐clinician e‐consultation program significantly reduced the elapsed time for cardiology consultation and initiation of OAC. The implementation of this program was associated with a lower risk of stroke and cardiovascular/all‐cause mortality.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Temporal Trend In Oral Anticoagulation Rate and Elapsed Time...mentioning

confidence: 93%

Section: Temporal Trend In Oral Anticoagulation Rate and Elapsed Time...mentioning

confidence: 99%

See 2 more Smart Citations

The impact of inter‐clinician electronic consultation in patients diagnosed with atrial fibrillation in primary care

Mazón‐Ramos

Cinza‐Sanjurjo

Garcia‐Vega

et al. 2022

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…Of note, a recent study reported that, in Spain, the progressive higher prescription of DOACs has been associated with a decrease in the incidence of AF-related ischaemic stroke. 39 It is not only important to reduce the risk of contagion for patients but also for healthcare professionals as they are an important risk group given their high exposure level. In fact, the main concern of healthcare professionals is contagion, particularly in the workplace.…”

Section: Update Of the Criteria To Be Considered For Anticoagulation ...mentioning

confidence: 99%

Dabigatran in patients with atrial fibrillation after COVID-19 hospitalization: an update of the ANIBAL* protocol

Cerezo-Manchado¹,

Birlanga²,

Romualdo³

et al. 2022

DIC

View full text Add to dashboard Cite

COVID-19 increases the risk of atrial fibrillation (AF) and thrombotic complications, particularly in severe cases, leading to higher mortality rates. Anticoagulation is the cornerstone to reduce thromboembolic risk in patients with AF. Considering the risk of hepatotoxicity in patients with severe COVID-19 as well as the risk of drug–drug interactions, drug-induced hepatotoxicity and bleeding, the ANIBAL protocol was developed to facilitate the anticoagulation approach at discharge after COVID-19 hospitalization. However, since the publication of the original algorithm, relevant changes have occurred. First, treatment of COVID-19 pneumonia has been modified with the use of dexamethasone or remdesivir during the first week in patients that require oxygen therapy, and of dexamethasone and/or tocilizumab or baricitinib during the second week in patients that necessitate supplementary oxygen or with a high inflammation state, respectively. On the other hand, metabolic syndrome is common in patients with AF as well as metabolic-associated fatty liver disease, and this could negatively impact the prognosis of patients with COVID-19, including high transaminase levels in patients treated with immunomodulators. The EHRA guidelines update also introduce some interesting changes in drug–drug interaction patterns with the reduction of the level of the interaction with dexamethasone, which is of paramount importance in this clinical context. Considering the new information, the protocol, named ANIBAL II, has been updated. In this new protocol, the anticoagulant of choice in patients with AF after COVID-19 hospitalization is provided according to three scenarios: with/without dexamethasone treatment at discharge and normal hepatic function, transaminases ≤2 times the upper limit of normal, or transaminases >2 times the upper limit of normal.

show abstract

Left atrial appendage orifice morphology in sickness and in health

Muge,

Seda,

Halil

et al. 2024

Herz

View full text Add to dashboard Cite

Epidemiology of atrial fibrillation-related ischemic stroke and its association with DOAC uptake in Spain: first national population-based study 2005 to 2018

Cited by 9 publications

References 13 publications

The impact of inter‐clinician electronic consultation in patients diagnosed with atrial fibrillation in primary care

The impact of inter‐clinician electronic consultation in patients diagnosed with atrial fibrillation in primary care

Dabigatran in patients with atrial fibrillation after COVID-19 hospitalization: an update of the ANIBAL* protocol

Left atrial appendage orifice morphology in sickness and in health

Contact Info

Product

Resources

About