Karl Georg Haeusler1, Serdar Tütüncü2, Claudia Kunze2, Johannes Schurig2,3, Carolin Malsch4,5, Janek Harder4, Silke Wiedmann4,6, Boris Dimitrijeski7, Martin Ebinger2,8, Georg Hagemann9, Frank Hamilton10, Martin Honermann11, Gerhard Jan Jungehulsing2,12, Andreas Kauert13, Hans-Christian Koennecke14, Christoph Leithner3, Bruno-Marcel Mackert10, Florian Masuhr15, Darius Nabavi7, Andrea Rocco3, Ingo Schmehl16, Bettina Schmitz17, Paul Sparenberg16, Robert Stingele18, Michael von Brevern19, Enrico Völzke20, Joanna Dietzel2, Peter U Heuschmann4,5, Matthias Endres2,3,21,22,23. 1. Department of Neurology, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, Würzburg, Germany. 2. Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Germany. 3. Department of Neurology, Charité - Universitätsmedizin Berlin, Germany. 4. Institute of Clinical Epidemiology and Biometry, University Würzburg, Germany. 5. Comprehensive Heart Failure Center, University of Würzburg, Clinical Trial Centre Würzburg, University Hospital Würzburg, Germany. 6. Strategic Corporate Development, Charité-Universitätsmedizin Berlin, Germany. 7. Department of Neurology, Vivantes Klinikum Neukölln, Berlin, Germany. 8. Department of Neurology, Medical Park Berlin Humboldtmühle, Berlin, Germany. 9. Department of Neurology, Helios Klinik Berlin-Buch, Berlin, Germany. 10. Department of Neurology, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany. 11. Department of Neurology, Vivantes Klinikum Spandau, Berlin, Germany. 12. Department of Neurology, Jüdisches Krankenhaus Berlin, Germany. 13. Department of Neurology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany. 14. Department of Neurology, Vivantes Klinikum im Friedrichshain, Berlin, Germany. 15. Department of Neurology, Bundeswehrkrankenhaus Berlin, Germany. 16. Department of Neurology, BG Klinikum Unfallkrankenhaus Berlin, Germany. 17. Department of Neurology, Vivantes Humboldt-Klinikum, Berlin, Germany. 18. Department of Neurology, German Red Cross Hospital Berlin, Köpenick, Germany. 19. Department of Neurology, Park-Klinik Weissensee, Berlin, Germany. 20. Department of Neurology, Schlosspark-Klinik Berlin, Germany. 21. German Center for Neurodegenerative Diseases (DZNE), Partner Site, Berlin, Germany. 22. German Center for Cardiovascular Diseases (DZHK), Partner Site, Berlin, Germany. 23. Berlin Institute of Health (BIH), Berlin, Germany.
Abstract
AIMS: The Berlin Atrial Fibrillation Registry was designed to analyse oral anticoagulation (OAC) prescription in patients with atrial fibrillation (AF) and acute ischaemic stroke. METHODS AND RESULTS: This investigator-initiated prospective multicentre registry enrolled patients at all 16 stroke units located in Berlin, Germany. The ongoing telephone follow-up is conducted centrally and will cover 5 years per patient. Within 2014 and 2016, 1080 patients gave written informed consent and 1048 patients were available for analysis. Median age was 77 years [interquartile range (IQR) 72-83], 503 (48%) patients were female, and 254 (24%) had a transient ischaemic attack (TIA). Overall, 470 (62%) out of 757 patients with known AF and a (pre-stroke) CHA2DS2-VASc ≥ 1 were anticoagulated at the time of stroke. At hospital discharge, 847 (81.3%) of 1042 patients were anticoagulated. Thereof 710 (68.1%) received a non-vitamin K-dependent oral anticoagulant (NOAC) and 137 (13.1%) a vitamin K antagonist (VKA). Pre-stroke intake of a NOAC [odds ratio (OR) 15.6 (95% confidence interval, 95% CI 1.97-122)] or VKA [OR 0.04 (95% CI 0.02-0.09)], an index TIA [OR 0.56 (95% CI 0.34-0.94)] rather than stroke, heart failure [OR 0.49 (95% CI 0.26-0.93)], and endovascular thrombectomy at hospital admission [OR 12.9 (95% CI 1.59-104)] were associated with NOAC prescription at discharge. Patients' age or AF type had no impact on OAC or NOAC use, respectively. CONCLUSION: About 60% of all registry patients with known AF received OAC at the time of stroke or TIA. At hospital discharge, more than 80% of AF patients were anticoagulated and about 80% of those were prescribed a NOAC. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The Berlin Atrial Fibrillation Registry was designed to analyse oral anticoagulation (OAC) prescription in patients with atrial fibrillation (AF) and acute ischaemic stroke. METHODS AND RESULTS: This investigator-initiated prospective multicentre registry enrolled patients at all 16 stroke units located in Berlin, Germany. The ongoing telephone follow-up is conducted centrally and will cover 5 years per patient. Within 2014 and 2016, 1080 patients gave written informed consent and 1048 patients were available for analysis. Median age was 77 years [interquartile range (IQR) 72-83], 503 (48%) patients were female, and 254 (24%) had a transient ischaemic attack (TIA). Overall, 470 (62%) out of 757 patients with known AF and a (pre-stroke) CHA2DS2-VASc ≥ 1 were anticoagulated at the time of stroke. At hospital discharge, 847 (81.3%) of 1042 patients were anticoagulated. Thereof 710 (68.1%) received a non-vitamin K-dependent oral anticoagulant (NOAC) and 137 (13.1%) a vitamin K antagonist (VKA). Pre-stroke intake of a NOAC [odds ratio (OR) 15.6 (95% confidence interval, 95% CI 1.97-122)] or VKA [OR 0.04 (95% CI 0.02-0.09)], an index TIA [OR 0.56 (95% CI 0.34-0.94)] rather than stroke, heart failure [OR 0.49 (95% CI 0.26-0.93)], and endovascular thrombectomy at hospital admission [OR 12.9 (95% CI 1.59-104)] were associated with NOAC prescription at discharge. Patients' age or AF type had no impact on OAC or NOAC use, respectively. CONCLUSION: About 60% of all registry patients with known AF received OAC at the time of stroke or TIA. At hospital discharge, more than 80% of AFpatients were anticoagulated and about 80% of those were prescribed a NOAC. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Serdar Tütüncü; Manuel Olma; Claudia Kunze; Joanna Dietzel; Johannes Schurig; Cornelia Fiessler; Carolin Malsch; Tobias Eberhard Haas; Boris Dimitrijeski; Wolfram Doehner; Georg Hagemann; Frank Hamilton; Martin Honermann; Gerhard Jan Jungehulsing; Andreas Kauert; Hans-Christian Koennecke; Bruno-Marcel Mackert; Darius Nabavi; Christian H Nolte; Joschua Mirko Reis; Ingo Schmehl; Paul Sparenberg; Robert Stingele; Enrico Völzke; Carolin Waldschmidt; Daniel Zeise-Wehry; Peter U Heuschmann; Matthias Endress; Karl Georg Haeusler Journal: J Neurol Date: 2021-10-31 Impact factor: 4.849