Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study

Özcan Başaran; Volkan Dogan; Osman Beton; Mehmet Tekinalp; Ahmet Çağrı Aykan; Ezgi Kalaycıoğlu; Ismail Bolat; Onur Taşar; Özgen Şafak; Macit Kalçık; Mehmet Yaman; Sinan İnci; Bernas Altıntaş; Sedat Kalkan; Cevat Kırma; Murat Biteker; Collaborators and Collaborators; Fatma Özpamuk Karadeniz; Ahmet İlker Tekkesin; Yasin Çakıllı; Ceyhan Türkkan; Mehmet Hamidi; Vahit Demir; Mustafa Ozan Gürsoy; Müjgan Tek Öztürk; Gökhan Aksan; Sabri Seyis; Mehmet Ballı; Mehmet Hayri Alıcı; Serdar Bozyel; Ibrahim Altun; Feyza Çalık; Oğuz Karaca; Füsun Helvacı; Kadriye Akay; Yiğit Çanga; Savaş Çelebi; Emine Altuntas; Mehmet Aytürk; Hacı Murat Güneş; Tahir Bezgin; Aytekin Aksakal; Beytullah Çakal; Ayşe Çolak; Özgür Kaplan; Adem Tatlısu; Gökhan Gözübüyük; Selami Demirelli; Adnan Kaya; İbrahim Rencüzoğulları; Zübeyde Bayram; Zeki Şimşek; Murat Civan; Ulaankhu Batgharel; Ali Ekber Ata; Gökhan Göl; Gurbet Özge Mert; Kadir Ugur Mert; Aleks Değirmencioğlu; Özkan Candan; Özlem Özcan Çelebi; Cem Doğan; Fethi Yavuz; Şeref Ulucan; Arif Arısoy; Bingül Dilekçi Şahin; Emrah Ermiş; Serkan Gökaslan; İdris Pektaş; Aslı Tanındı; Kamuran Tekin; Kadriye Memic Sancar; Edip Güvenç Çekiç; Nesrin Filiz Başaran

doi:10.1007/s11239-016-1445-1

Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study

Özcan Başaran, Volkan Dogan, Osman Beton, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, Ismail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Mehmet Yaman, Sinan İnci, Bernas Altıntaş, Sedat Kalkan, Cevat Kırma, Murat Biteker, Collaborators and Collaborators, Fatma Özpamuk Karadeniz, Ahmet İlker Tekkesin, Yasin ÇakıllıCeyhan Türkkan, Mehmet Hamidi, Vahit Demir, Mustafa Ozan Gürsoy, Müjgan Tek Öztürk, Gökhan Aksan, Sabri Seyis, Mehmet Ballı, Mehmet Hayri Alıcı, Serdar Bozyel, Ibrahim Altun, Feyza Çalık, Oğuz Karaca, Füsun Helvacı, Kadriye Akay, Yiğit Çanga, Savaş Çelebi, Emine Altuntas, Mehmet Aytürk, Hacı Murat Güneş, Tahir Bezgin, Aytekin Aksakal, Beytullah Çakal, Ayşe Çolak, Özgür Kaplan, Adem Tatlısu, Gökhan Gözübüyük, Selami Demirelli, Adnan Kaya, İbrahim Rencüzoğulları, Zübeyde Bayram, Zeki Şimşek, Murat Civan, Ulaankhu Batgharel, Ali Ekber Ata, Gökhan Göl, Gurbet Özge Mert, Kadir Ugur Mert, Aleks Değirmencioğlu, Özkan Candan, Özlem Özcan Çelebi, Cem Doğan, Fethi Yavuz, Şeref Ulucan, Arif Arısoy, Bingül Dilekçi Şahin, Emrah Ermiş, Serkan Gökaslan, İdris Pektaş, Aslı Tanındı, Kamuran Tekin, Kadriye Memic Sancar, Edip Güvenç Çekiç, Nesrin Filiz Başaran

Araştırma sonucu: Dergi katkısı › Makale › bilirkişi

2 Alıntılar (Scopus)

Özet

The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded. Baseline characteristics and oral anticoagulant (OAC) therapies were compared. In 5987 patients with NVAF, there were 3929 (66%) NSVD and 2058 (34%) SVD patients. The predominant valvular disease was mitral regurgitation (58.1%), followed by aortic regurgitation (24.1%) and aortic stenosis (17.8%). Patients with SVD had higher CHA₂DS₂VASc [3.0 (2.0; 4.0) vs. 4.0 (2.0; 5.0), p < 0.001] and HAS-BLED [2.0 (1.0; 2.0) vs. 2.0 (1.0; 2.0), p = 0.004] scores compared to patients with NSVD. Overall, 2763 (71.2%) of NSVD and 1515 (73.8%) of SVD patients were on OAC therapy (p = 0.035). When the patients with SVD were analyzed separately, the mean CHA₂DS₂VASc and HAS-BLED scores were higher in patients with mitral regurgitation compared to patients with aortic regurgitation and aortic stenosis [4.0 (3.0; 5.0), 3.0 (2.0; 4.0), 3.0 (2.0; 4.0) p < 0.001 and 2.0 (1.0; 3.0), 1.0 (1.0; 2.0), 1.0 (0.0; 2.0) p < 0.001, respectively]. In patients with SVD, 65.7% of mitral regurgitation, 82.6% of aortic regurgitation and 88.0% of aortic stenosis patients were on OAC therapy. One out of three NVAF patients had at least one moderate valvular heart disease with the predominance of mitral regurgitation. Patients with SVD were at greater risk of stroke and bleeding compared to patients with NSVD. Although patients with mitral regurgitation should be given more aggressive anticoagulant therapy due to their higher risk of stroke, they are undertreated compared to patients with aortic valve diseases.

Orijinal dil	İngilizce
Sayfa (başlangıç-bitiş)	157-165
Sayfa sayısı	9
Dergi	Journal of Thrombosis and Thrombolysis
Hacim	43
Basın numarası	2
DOI'lar	https://doi.org/10.1007/s11239-016-1445-1
Yayın durumu	Yayınlanan - 1 Şub 2017

Belgeye Erişim

10.1007/s11239-016-1445-1

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Başaran, Ö., Dogan, V., Beton, O., Tekinalp, M., Aykan, A. Ç., Kalaycıoğlu, E., Bolat, I., Taşar, O., Şafak, Ö., Kalçık, M., Yaman, M., İnci, S., Altıntaş, B., Kalkan, S., Kırma, C., Biteker, M., and Collaborators, C., Karadeniz, F. Ö., Tekkesin, A. İ., ... Başaran, N. F. (2017). Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study. Journal of Thrombosis and Thrombolysis, 43(2), 157-165. https://doi.org/10.1007/s11239-016-1445-1

@article{37bd01d109ac465caf98f3238731a495,

title = "Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study",

abstract = "The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded. Baseline characteristics and oral anticoagulant (OAC) therapies were compared. In 5987 patients with NVAF, there were 3929 (66%) NSVD and 2058 (34%) SVD patients. The predominant valvular disease was mitral regurgitation (58.1%), followed by aortic regurgitation (24.1%) and aortic stenosis (17.8%). Patients with SVD had higher CHA2DS2VASc [3.0 (2.0; 4.0) vs. 4.0 (2.0; 5.0), p < 0.001] and HAS-BLED [2.0 (1.0; 2.0) vs. 2.0 (1.0; 2.0), p = 0.004] scores compared to patients with NSVD. Overall, 2763 (71.2%) of NSVD and 1515 (73.8%) of SVD patients were on OAC therapy (p = 0.035). When the patients with SVD were analyzed separately, the mean CHA2DS2VASc and HAS-BLED scores were higher in patients with mitral regurgitation compared to patients with aortic regurgitation and aortic stenosis [4.0 (3.0; 5.0), 3.0 (2.0; 4.0), 3.0 (2.0; 4.0) p < 0.001 and 2.0 (1.0; 3.0), 1.0 (1.0; 2.0), 1.0 (0.0; 2.0) p < 0.001, respectively]. In patients with SVD, 65.7% of mitral regurgitation, 82.6% of aortic regurgitation and 88.0% of aortic stenosis patients were on OAC therapy. One out of three NVAF patients had at least one moderate valvular heart disease with the predominance of mitral regurgitation. Patients with SVD were at greater risk of stroke and bleeding compared to patients with NSVD. Although patients with mitral regurgitation should be given more aggressive anticoagulant therapy due to their higher risk of stroke, they are undertreated compared to patients with aortic valve diseases.",

keywords = "Atrial fibrillation, Non-valvular atrial fibrillation, Oral anticoagulant therapy, Valvular heart disease",

author = "{\"O}zcan Ba{\c s}aran and Volkan Dogan and Osman Beton and Mehmet Tekinalp and Aykan, {Ahmet {\c C}ağrı} and Ezgi Kalaycıoğlu and Ismail Bolat and Onur Ta{\c s}ar and {\"O}zgen {\c S}afak and Macit Kal{\c c}ık and Mehmet Yaman and Sinan İnci and Bernas Altınta{\c s} and Sedat Kalkan and Cevat Kırma and Murat Biteker and {and Collaborators}, Collaborators and Karadeniz, {Fatma {\"O}zpamuk} and Tekkesin, {Ahmet İlker} and Yasin {\c C}akıllı and Ceyhan T{\"u}rkkan and Mehmet Hamidi and Vahit Demir and G{\"u}rsoy, {Mustafa Ozan} and {\"O}zt{\"u}rk, {M{\"u}jgan Tek} and G{\"o}khan Aksan and Sabri Seyis and Mehmet Ballı and Alıcı, {Mehmet Hayri} and Serdar Bozyel and Ibrahim Altun and Feyza {\c C}alık and Oğuz Karaca and F{\"u}sun Helvacı and Kadriye Akay and Yiğit {\c C}anga and Sava{\c s} {\c C}elebi and Emine Altuntas and Mehmet Ayt{\"u}rk and G{\"u}ne{\c s}, {Hacı Murat} and Tahir Bezgin and Aytekin Aksakal and Beytullah {\c C}akal and Ay{\c s}e {\c C}olak and {\"O}zg{\"u}r Kaplan and Adem Tatlısu and G{\"o}khan G{\"o}z{\"u}b{\"u}y{\"u}k and Selami Demirelli and Adnan Kaya and İbrahim Renc{\"u}zoğulları and Z{\"u}beyde Bayram and Zeki {\c S}im{\c s}ek and Murat Civan and Ulaankhu Batgharel and Ata, {Ali Ekber} and G{\"o}khan G{\"o}l and Mert, {Gurbet {\"O}zge} and Mert, {Kadir Ugur} and Aleks Değirmencioğlu and {\"O}zkan Candan and {\c C}elebi, {{\"O}zlem {\"O}zcan} and Cem Doğan and Fethi Yavuz and {\c S}eref Ulucan and Arif Arısoy and {\c S}ahin, {Bing{\"u}l Dilek{\c c}i} and Emrah Ermi{\c s} and Serkan G{\"o}kaslan and İdris Pekta{\c s} and Aslı Tanındı and Kamuran Tekin and Sancar, {Kadriye Memic} and {\c C}eki{\c c}, {Edip G{\"u}ven{\c c}} and Ba{\c s}aran, {Nesrin Filiz}",

note = "Publisher Copyright: {\textcopyright} 2016, Springer Science+Business Media New York.",

year = "2017",

month = feb,

day = "1",

doi = "10.1007/s11239-016-1445-1",

language = "English",

volume = "43",

pages = "157--165",

journal = "Journal of Thrombosis and Thrombolysis",

issn = "0929-5305",

publisher = "Springer Netherlands",

number = "2",

}

Başaran, Ö, Dogan, V, Beton, O, Tekinalp, M, Aykan, AÇ, Kalaycıoğlu, E, Bolat, I, Taşar, O, Şafak, Ö, Kalçık, M, Yaman, M, İnci, S, Altıntaş, B, Kalkan, S, Kırma, C, Biteker, M, and Collaborators, C, Karadeniz, FÖ, Tekkesin, Aİ, Çakıllı, Y, Türkkan, C, Hamidi, M, Demir, V, Gürsoy, MO, Öztürk, MT, Aksan, G, Seyis, S, Ballı, M, Alıcı, MH, Bozyel, S, Altun, I, Çalık, F, Karaca, O, Helvacı, F, Akay, K, Çanga, Y, Çelebi, S, Altuntas, E, Aytürk, M, Güneş, HM, Bezgin, T, Aksakal, A, Çakal, B, Çolak, A, Kaplan, Ö, Tatlısu, A, Gözübüyük, G, Demirelli, S, Kaya, A, Rencüzoğulları, İ, Bayram, Z, Şimşek, Z, Civan, M, Batgharel, U, Ata, AE, Göl, G, Mert, GÖ, Mert, KU, Değirmencioğlu, A, Candan, Ö, Çelebi, ÖÖ, Doğan, C, Yavuz, F, Ulucan, Ş, Arısoy, A, Şahin, BD, Ermiş, E, Gökaslan, S, Pektaş, İ, Tanındı, A, Tekin, K, Sancar, KM, Çekiç, EG & Başaran, NF 2017, 'Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study', Journal of Thrombosis and Thrombolysis, hac. 43, no. 2, pp. 157-165. https://doi.org/10.1007/s11239-016-1445-1

TY - JOUR

T1 - Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation

T2 - results from the RAMSES study

AU - Başaran, Özcan

AU - Dogan, Volkan

AU - Beton, Osman

AU - Tekinalp, Mehmet

AU - Aykan, Ahmet Çağrı

AU - Kalaycıoğlu, Ezgi

AU - Bolat, Ismail

AU - Taşar, Onur

AU - Şafak, Özgen

AU - Kalçık, Macit

AU - Yaman, Mehmet

AU - İnci, Sinan

AU - Altıntaş, Bernas

AU - Kalkan, Sedat

AU - Kırma, Cevat

AU - Biteker, Murat

AU - and Collaborators, Collaborators

AU - Karadeniz, Fatma Özpamuk

AU - Tekkesin, Ahmet İlker

AU - Çakıllı, Yasin

AU - Türkkan, Ceyhan

AU - Hamidi, Mehmet

AU - Demir, Vahit

AU - Gürsoy, Mustafa Ozan

AU - Öztürk, Müjgan Tek

AU - Aksan, Gökhan

AU - Seyis, Sabri

AU - Ballı, Mehmet

AU - Alıcı, Mehmet Hayri

AU - Bozyel, Serdar

AU - Altun, Ibrahim

AU - Çalık, Feyza

AU - Karaca, Oğuz

AU - Helvacı, Füsun

AU - Akay, Kadriye

AU - Çanga, Yiğit

AU - Çelebi, Savaş

AU - Altuntas, Emine

AU - Aytürk, Mehmet

AU - Güneş, Hacı Murat

AU - Bezgin, Tahir

AU - Aksakal, Aytekin

AU - Çakal, Beytullah

AU - Çolak, Ayşe

AU - Kaplan, Özgür

AU - Tatlısu, Adem

AU - Gözübüyük, Gökhan

AU - Demirelli, Selami

AU - Kaya, Adnan

AU - Rencüzoğulları, İbrahim

AU - Bayram, Zübeyde

AU - Şimşek, Zeki

AU - Civan, Murat

AU - Batgharel, Ulaankhu

AU - Ata, Ali Ekber

AU - Göl, Gökhan

AU - Mert, Gurbet Özge

AU - Mert, Kadir Ugur

AU - Değirmencioğlu, Aleks

AU - Candan, Özkan

AU - Çelebi, Özlem Özcan

AU - Doğan, Cem

AU - Yavuz, Fethi

AU - Ulucan, Şeref

AU - Arısoy, Arif

AU - Şahin, Bingül Dilekçi

AU - Ermiş, Emrah

AU - Gökaslan, Serkan

AU - Pektaş, İdris

AU - Tanındı, Aslı

AU - Tekin, Kamuran

AU - Sancar, Kadriye Memic

AU - Çekiç, Edip Güvenç

AU - Başaran, Nesrin Filiz

PY - 2017/2/1

Y1 - 2017/2/1

N2 - The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded. Baseline characteristics and oral anticoagulant (OAC) therapies were compared. In 5987 patients with NVAF, there were 3929 (66%) NSVD and 2058 (34%) SVD patients. The predominant valvular disease was mitral regurgitation (58.1%), followed by aortic regurgitation (24.1%) and aortic stenosis (17.8%). Patients with SVD had higher CHA2DS2VASc [3.0 (2.0; 4.0) vs. 4.0 (2.0; 5.0), p < 0.001] and HAS-BLED [2.0 (1.0; 2.0) vs. 2.0 (1.0; 2.0), p = 0.004] scores compared to patients with NSVD. Overall, 2763 (71.2%) of NSVD and 1515 (73.8%) of SVD patients were on OAC therapy (p = 0.035). When the patients with SVD were analyzed separately, the mean CHA2DS2VASc and HAS-BLED scores were higher in patients with mitral regurgitation compared to patients with aortic regurgitation and aortic stenosis [4.0 (3.0; 5.0), 3.0 (2.0; 4.0), 3.0 (2.0; 4.0) p < 0.001 and 2.0 (1.0; 3.0), 1.0 (1.0; 2.0), 1.0 (0.0; 2.0) p < 0.001, respectively]. In patients with SVD, 65.7% of mitral regurgitation, 82.6% of aortic regurgitation and 88.0% of aortic stenosis patients were on OAC therapy. One out of three NVAF patients had at least one moderate valvular heart disease with the predominance of mitral regurgitation. Patients with SVD were at greater risk of stroke and bleeding compared to patients with NSVD. Although patients with mitral regurgitation should be given more aggressive anticoagulant therapy due to their higher risk of stroke, they are undertreated compared to patients with aortic valve diseases.

AB - The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded. Baseline characteristics and oral anticoagulant (OAC) therapies were compared. In 5987 patients with NVAF, there were 3929 (66%) NSVD and 2058 (34%) SVD patients. The predominant valvular disease was mitral regurgitation (58.1%), followed by aortic regurgitation (24.1%) and aortic stenosis (17.8%). Patients with SVD had higher CHA2DS2VASc [3.0 (2.0; 4.0) vs. 4.0 (2.0; 5.0), p < 0.001] and HAS-BLED [2.0 (1.0; 2.0) vs. 2.0 (1.0; 2.0), p = 0.004] scores compared to patients with NSVD. Overall, 2763 (71.2%) of NSVD and 1515 (73.8%) of SVD patients were on OAC therapy (p = 0.035). When the patients with SVD were analyzed separately, the mean CHA2DS2VASc and HAS-BLED scores were higher in patients with mitral regurgitation compared to patients with aortic regurgitation and aortic stenosis [4.0 (3.0; 5.0), 3.0 (2.0; 4.0), 3.0 (2.0; 4.0) p < 0.001 and 2.0 (1.0; 3.0), 1.0 (1.0; 2.0), 1.0 (0.0; 2.0) p < 0.001, respectively]. In patients with SVD, 65.7% of mitral regurgitation, 82.6% of aortic regurgitation and 88.0% of aortic stenosis patients were on OAC therapy. One out of three NVAF patients had at least one moderate valvular heart disease with the predominance of mitral regurgitation. Patients with SVD were at greater risk of stroke and bleeding compared to patients with NSVD. Although patients with mitral regurgitation should be given more aggressive anticoagulant therapy due to their higher risk of stroke, they are undertreated compared to patients with aortic valve diseases.

KW - Atrial fibrillation

KW - Non-valvular atrial fibrillation

KW - Oral anticoagulant therapy

KW - Valvular heart disease

UR - http://www.scopus.com/inward/record.url?scp=84995376500&partnerID=8YFLogxK

U2 - 10.1007/s11239-016-1445-1

DO - 10.1007/s11239-016-1445-1

M3 - Article

C2 - 27848065

AN - SCOPUS:84995376500

SN - 0929-5305

VL - 43

SP - 157

EP - 165

JO - Journal of Thrombosis and Thrombolysis

JF - Journal of Thrombosis and Thrombolysis

IS - 2

ER -

Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study

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