Atrial Fibrillation Management in Acute Stroke Patients in Turkiye: Real-life Data from the NoroTek Study/Turkiye'de Inme Hastalarinda Atrial Fibrilasyonun Yonetimi: NoroTek Calismasi Gercek? Hayat Verileri
Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were col...
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| Veröffentlicht in: | Türk nöroloji dergisi 2023-09, Vol.29 (3), p.183 |
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| creator | Topcuolu, Mehmet Akif Arsava, Ethem Murat Ozdemir, Atilla Ozcan Aykac, Ozlem Cetiner, Mustafa Gencer, Elif Sarionder Gunes, Aygul Yaka, Erdem Ocek, Levent Tannverdi, Zeynep Tekan, Ulgen Yalaz Ozkan, Esra Sirin, Hadiye Guler, Ayse Kursun, Oguzhan Kunt, Refik Cenikli, Utku Acar, Bilgehan Kablan, Yuksel Isikay, Canan Togay Aslanbaba, Eda Sorgun, Mine Bektas, Hesna Cabalar, Murat Yayla, Vildan Erdogan, Haci Ali Bavli, Songul Ongun, Nedim Keskin, Ahmet Onur Akdoan, Ozlem Emre, Ufuk Yildiz, Ozlem Kayim Bolayir, Asli Karadeli, Hasan Huseyin zel, Tugba Unal, Ali Dora, Babur Arer, Zlfikar Eren, Alper Milanoglu, Aysel Nazliel, Bijen Caglayan, Hale Batur Guven, Bulent Erdogan, Mucahid Acar, Zeynep OzdemirBakar, Mustafa Senadim, Songul Asil, Talip Demir, Turgay Unsal, Yaprak Ozum Eskut, Neslihan Bas, Demet Funda Sener, Ufuk Degirmenci, Bahar Aluclu, Ufuk Batan, Birgul Acar, Zeynep Niflioglu, Buket Yazici, Duran Aytac, Emrah Ince, Fatma Birsen Ay, Halil Onder, Halil Kozak, Hasan Huseyin Ilgezdi, Irem Bilgic, Adnan Burak Akyol, Senol Gungor, I. Levent Atmaca, Murat Mert Sen, Mustafa Akkas, Sinem Yazici Yolda, Tahir Cinar, Bilge Piri Yilmaz, Arda Genc, Hamit Kisabay, Aysin Ilik, Faik Demirbas, Hayri Duman, Taskin Demir, Tulin Can, Ufuk Yurekli, Vedat Ali Bozdogan, Zehra Kaya, Dilaver Afsar, Nazire Gurkas, Erdem Toplutas, Eren Degirmenci, Eylem Aydn, Isa Epceliden, M. Tuncay Turgut, Nilda Kale, Nilufer Coban, Eda Yesilot, Nilufer Ekizoglu, Esme Kizek, Ozgu Bilgili, Ozlem Baydemir, Recep Akcakoyunlu, Merve Yilmaz, Zahide Ozturk, Serefnur |
| description | Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio [greater than or equal to]2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NoroTek (TR) revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known A F. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by A F. Keywords: Acute stroke, transient ischemic attack, anticoagulant, relapse, therapeutic dose, Holter monitoring Amac: Atrial fibrilasyon (AF) iskemik inmenin dogrudan onlenebilir en sik nedendir. Ulkemizde AF nedenli inme spek |
| doi_str_mv | 10.4274/tnd.2023.99492 |
| format | Article |
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Hayat Verileri</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Topcuolu, Mehmet Akif ; Arsava, Ethem Murat ; Ozdemir, Atilla Ozcan ; Aykac, Ozlem ; Cetiner, Mustafa ; Gencer, Elif Sarionder ; Gunes, Aygul ; Yaka, Erdem ; Ocek, Levent ; Tannverdi, Zeynep ; Tekan, Ulgen Yalaz ; Ozkan, Esra ; Sirin, Hadiye ; Guler, Ayse ; Kursun, Oguzhan ; Kunt, Refik ; Cenikli, Utku ; Acar, Bilgehan ; Kablan, Yuksel ; Isikay, Canan Togay ; Aslanbaba, Eda ; Sorgun, Mine ; Bektas, Hesna ; Cabalar, Murat ; Yayla, Vildan ; Erdogan, Haci Ali ; Bavli, Songul ; Ongun, Nedim ; Keskin, Ahmet Onur ; Akdoan, Ozlem ; Emre, Ufuk ; Yildiz, Ozlem Kayim ; Bolayir, Asli ; Karadeli, Hasan Huseyin ; zel, Tugba ; Unal, Ali ; Dora, Babur ; Arer, Zlfikar ; Eren, Alper ; Milanoglu, Aysel ; Nazliel, Bijen ; Caglayan, Hale Batur ; Guven, Bulent ; Erdogan, Mucahid ; Acar, Zeynep OzdemirBakar, Mustafa ; Senadim, Songul ; Asil, Talip ; Demir, Turgay ; Unsal, Yaprak Ozum ; Eskut, Neslihan ; Bas, Demet Funda ; Sener, Ufuk ; Degirmenci, Bahar ; Aluclu, Ufuk ; Batan, Birgul ; Acar, Zeynep ; Niflioglu, Buket ; Yazici, Duran ; Aytac, Emrah ; Ince, Fatma Birsen ; Ay, Halil ; Onder, Halil ; Kozak, Hasan Huseyin ; Ilgezdi, Irem ; Bilgic, Adnan Burak ; Akyol, Senol ; Gungor, I. Levent ; Atmaca, Murat Mert ; Sen, Mustafa ; Akkas, Sinem Yazici ; Yolda, Tahir ; Cinar, Bilge Piri ; Yilmaz, Arda ; Genc, Hamit ; Kisabay, Aysin ; Ilik, Faik ; Demirbas, Hayri ; Duman, Taskin ; Demir, Tulin ; Can, Ufuk ; Yurekli, Vedat Ali ; Bozdogan, Zehra ; Kaya, Dilaver ; Afsar, Nazire ; Gurkas, Erdem ; Toplutas, Eren ; Degirmenci, Eylem ; Aydn, Isa ; Epceliden, M. Tuncay ; Turgut, Nilda ; Kale, Nilufer ; Coban, Eda ; Yesilot, Nilufer ; Ekizoglu, Esme ; Kizek, Ozgu ; Bilgili, Ozlem ; Baydemir, Recep ; Akcakoyunlu, Merve ; Yilmaz, Zahide ; Ozturk, Serefnur</creator><creatorcontrib>Topcuolu, Mehmet Akif ; Arsava, Ethem Murat ; Ozdemir, Atilla Ozcan ; Aykac, Ozlem ; Cetiner, Mustafa ; Gencer, Elif Sarionder ; Gunes, Aygul ; Yaka, Erdem ; Ocek, Levent ; Tannverdi, Zeynep ; Tekan, Ulgen Yalaz ; Ozkan, Esra ; Sirin, Hadiye ; Guler, Ayse ; Kursun, Oguzhan ; Kunt, Refik ; Cenikli, Utku ; Acar, Bilgehan ; Kablan, Yuksel ; Isikay, Canan Togay ; Aslanbaba, Eda ; Sorgun, Mine ; Bektas, Hesna ; Cabalar, Murat ; Yayla, Vildan ; Erdogan, Haci Ali ; Bavli, Songul ; Ongun, Nedim ; Keskin, Ahmet Onur ; Akdoan, Ozlem ; Emre, Ufuk ; Yildiz, Ozlem Kayim ; Bolayir, Asli ; Karadeli, Hasan Huseyin ; zel, Tugba ; Unal, Ali ; Dora, Babur ; Arer, Zlfikar ; Eren, Alper ; Milanoglu, Aysel ; Nazliel, Bijen ; Caglayan, Hale Batur ; Guven, Bulent ; Erdogan, Mucahid ; Acar, Zeynep OzdemirBakar, Mustafa ; Senadim, Songul ; Asil, Talip ; Demir, Turgay ; Unsal, Yaprak Ozum ; Eskut, Neslihan ; Bas, Demet Funda ; Sener, Ufuk ; Degirmenci, Bahar ; Aluclu, Ufuk ; Batan, Birgul ; Acar, Zeynep ; Niflioglu, Buket ; Yazici, Duran ; Aytac, Emrah ; Ince, Fatma Birsen ; Ay, Halil ; Onder, Halil ; Kozak, Hasan Huseyin ; Ilgezdi, Irem ; Bilgic, Adnan Burak ; Akyol, Senol ; Gungor, I. Levent ; Atmaca, Murat Mert ; Sen, Mustafa ; Akkas, Sinem Yazici ; Yolda, Tahir ; Cinar, Bilge Piri ; Yilmaz, Arda ; Genc, Hamit ; Kisabay, Aysin ; Ilik, Faik ; Demirbas, Hayri ; Duman, Taskin ; Demir, Tulin ; Can, Ufuk ; Yurekli, Vedat Ali ; Bozdogan, Zehra ; Kaya, Dilaver ; Afsar, Nazire ; Gurkas, Erdem ; Toplutas, Eren ; Degirmenci, Eylem ; Aydn, Isa ; Epceliden, M. Tuncay ; Turgut, Nilda ; Kale, Nilufer ; Coban, Eda ; Yesilot, Nilufer ; Ekizoglu, Esme ; Kizek, Ozgu ; Bilgili, Ozlem ; Baydemir, Recep ; Akcakoyunlu, Merve ; Yilmaz, Zahide ; Ozturk, Serefnur</creatorcontrib><description>Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio [greater than or equal to]2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NoroTek (TR) revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known A F. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by A F. Keywords: Acute stroke, transient ischemic attack, anticoagulant, relapse, therapeutic dose, Holter monitoring Amac: Atrial fibrilasyon (AF) iskemik inmenin dogrudan onlenebilir en sik nedendir. Ulkemizde AF nedenli inme spektrumuna dair noroloji kaynakli genis olcekte bir veri bulunmamaktadir. NoroTek-Turkiye (TR) kapsaminda akut inme algoritmalarinin olusturulmasina katki yapmasi beklenen AF tespit edilen akut inme hastalarina dair hastane verisi toplanmistir. Gerec ve Yontem: 10 Mayis 2018 Dunya Inme Farkindalik Gunu'nde 30 saglik bolgesine yer alan 87 noroloji biriminde yatmakta olan 1.790 hasta prospektif olarak degerlendirilmistir. Calismada yer alan toplam 929 hasta [859 akut iskemik inme, 70 gecici iskemik atak (GIA)] bu analize dahil edilmistir. Bulgular: Iskemik inme/GIA sebebiyle ile interne edilmis hastalarda AF orani %29,8 olup bunlarin %65'i bilinmekte olan, %5'i paroksismal ve %30'u yeni tanidir. AF tanisi ile gelen hastalarda "etkin" tedavi [internasyonel normalizasyon orani [greater than or equal to]2,0 varfarin veya rehber dozunda non-vitamin K antagonist oral antikoagulan (NOAK)] alanlarin orani %25,3 olup, %42,5 olguda ya hic ilac kullanilmamakta ya da sadece antiplatelet kullanilmaktaydi. Dusuk doz kullanim orani 42 NOAK alirken inme gecirmis olguda %50 idi. Taburcu edilirken antikoagulan %94,6 (dusuk molekul agirlikli veya non-fraksiyone heparin %28,1; varfarin %32,5 ve NOAK %31) hastaya recete edilmisti. NOAK ile taburcu edilen olgularin %22'sinde doz dusuk kategoride olup geliste NOAK almakta olan olgularin yarisi ayni ilacla taburcu edilmistir. Sonuc: NoroTek (TR) ulkemizde AF'nin akut inmedeki sikligi yani sira sekonder proflaksi perspektifinde yonetiminin gelistirilebilecek yonlerini ortaya koydu. Turkiye'de hastanede yatan akut inme olgularinin yaklasik ucte birinde AF saptanmistir. AF'si bilinen akut inme olgularinin dortte ucunde etkin antikoagulan tedavi kullanilmamaktaydi. AF'de inme sekonder proflaksisi kapsaminda heparin, varfarin ve NOAK planlamasi benzer siklikta (ucte bir) olup recete edilen NOAK dozu dortte bir olguda subterapotiktir. AF'ye bagli inmenin onlenebilmesi non-medikal ve medikal egitim gerekli gorunmektedir. Anahtar Kelimeler: Akut inme, gecici iskemik atak, antikoagulan, nuks, terapotik doz, Holter monitorizasyon</description><identifier>ISSN: 1301-062X</identifier><identifier>DOI: 10.4274/tnd.2023.99492</identifier><language>eng</language><publisher>Galenos Yayinevi Tic. Ltd</publisher><subject>Apixaban ; Atrial fibrillation ; Clopidogrel ; Ischemia ; Stroke (Disease) ; Stroke patients ; Warfarin</subject><ispartof>Türk nöroloji dergisi, 2023-09, Vol.29 (3), p.183</ispartof><rights>COPYRIGHT 2023 Galenos Yayinevi Tic. Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids></links><search><creatorcontrib>Topcuolu, Mehmet Akif</creatorcontrib><creatorcontrib>Arsava, Ethem Murat</creatorcontrib><creatorcontrib>Ozdemir, Atilla Ozcan</creatorcontrib><creatorcontrib>Aykac, Ozlem</creatorcontrib><creatorcontrib>Cetiner, Mustafa</creatorcontrib><creatorcontrib>Gencer, Elif Sarionder</creatorcontrib><creatorcontrib>Gunes, Aygul</creatorcontrib><creatorcontrib>Yaka, Erdem</creatorcontrib><creatorcontrib>Ocek, Levent</creatorcontrib><creatorcontrib>Tannverdi, Zeynep</creatorcontrib><creatorcontrib>Tekan, Ulgen Yalaz</creatorcontrib><creatorcontrib>Ozkan, Esra</creatorcontrib><creatorcontrib>Sirin, Hadiye</creatorcontrib><creatorcontrib>Guler, Ayse</creatorcontrib><creatorcontrib>Kursun, Oguzhan</creatorcontrib><creatorcontrib>Kunt, Refik</creatorcontrib><creatorcontrib>Cenikli, Utku</creatorcontrib><creatorcontrib>Acar, Bilgehan</creatorcontrib><creatorcontrib>Kablan, Yuksel</creatorcontrib><creatorcontrib>Isikay, Canan Togay</creatorcontrib><creatorcontrib>Aslanbaba, Eda</creatorcontrib><creatorcontrib>Sorgun, Mine</creatorcontrib><creatorcontrib>Bektas, Hesna</creatorcontrib><creatorcontrib>Cabalar, Murat</creatorcontrib><creatorcontrib>Yayla, Vildan</creatorcontrib><creatorcontrib>Erdogan, Haci Ali</creatorcontrib><creatorcontrib>Bavli, Songul</creatorcontrib><creatorcontrib>Ongun, Nedim</creatorcontrib><creatorcontrib>Keskin, Ahmet Onur</creatorcontrib><creatorcontrib>Akdoan, Ozlem</creatorcontrib><creatorcontrib>Emre, Ufuk</creatorcontrib><creatorcontrib>Yildiz, Ozlem Kayim</creatorcontrib><creatorcontrib>Bolayir, Asli</creatorcontrib><creatorcontrib>Karadeli, Hasan Huseyin</creatorcontrib><creatorcontrib>zel, Tugba</creatorcontrib><creatorcontrib>Unal, Ali</creatorcontrib><creatorcontrib>Dora, Babur</creatorcontrib><creatorcontrib>Arer, Zlfikar</creatorcontrib><creatorcontrib>Eren, Alper</creatorcontrib><creatorcontrib>Milanoglu, Aysel</creatorcontrib><creatorcontrib>Nazliel, Bijen</creatorcontrib><creatorcontrib>Caglayan, Hale Batur</creatorcontrib><creatorcontrib>Guven, Bulent</creatorcontrib><creatorcontrib>Erdogan, Mucahid</creatorcontrib><creatorcontrib>Acar, Zeynep OzdemirBakar, Mustafa</creatorcontrib><creatorcontrib>Senadim, Songul</creatorcontrib><creatorcontrib>Asil, Talip</creatorcontrib><creatorcontrib>Demir, Turgay</creatorcontrib><creatorcontrib>Unsal, Yaprak Ozum</creatorcontrib><creatorcontrib>Eskut, Neslihan</creatorcontrib><creatorcontrib>Bas, Demet Funda</creatorcontrib><creatorcontrib>Sener, Ufuk</creatorcontrib><creatorcontrib>Degirmenci, Bahar</creatorcontrib><creatorcontrib>Aluclu, Ufuk</creatorcontrib><creatorcontrib>Batan, Birgul</creatorcontrib><creatorcontrib>Acar, Zeynep</creatorcontrib><creatorcontrib>Niflioglu, Buket</creatorcontrib><creatorcontrib>Yazici, Duran</creatorcontrib><creatorcontrib>Aytac, Emrah</creatorcontrib><creatorcontrib>Ince, Fatma Birsen</creatorcontrib><creatorcontrib>Ay, Halil</creatorcontrib><creatorcontrib>Onder, Halil</creatorcontrib><creatorcontrib>Kozak, Hasan Huseyin</creatorcontrib><creatorcontrib>Ilgezdi, Irem</creatorcontrib><creatorcontrib>Bilgic, Adnan Burak</creatorcontrib><creatorcontrib>Akyol, Senol</creatorcontrib><creatorcontrib>Gungor, I. Levent</creatorcontrib><creatorcontrib>Atmaca, Murat Mert</creatorcontrib><creatorcontrib>Sen, Mustafa</creatorcontrib><creatorcontrib>Akkas, Sinem Yazici</creatorcontrib><creatorcontrib>Yolda, Tahir</creatorcontrib><creatorcontrib>Cinar, Bilge Piri</creatorcontrib><creatorcontrib>Yilmaz, Arda</creatorcontrib><creatorcontrib>Genc, Hamit</creatorcontrib><creatorcontrib>Kisabay, Aysin</creatorcontrib><creatorcontrib>Ilik, Faik</creatorcontrib><creatorcontrib>Demirbas, Hayri</creatorcontrib><creatorcontrib>Duman, Taskin</creatorcontrib><creatorcontrib>Demir, Tulin</creatorcontrib><creatorcontrib>Can, Ufuk</creatorcontrib><creatorcontrib>Yurekli, Vedat Ali</creatorcontrib><creatorcontrib>Bozdogan, Zehra</creatorcontrib><creatorcontrib>Kaya, Dilaver</creatorcontrib><creatorcontrib>Afsar, Nazire</creatorcontrib><creatorcontrib>Gurkas, Erdem</creatorcontrib><creatorcontrib>Toplutas, Eren</creatorcontrib><creatorcontrib>Degirmenci, Eylem</creatorcontrib><creatorcontrib>Aydn, Isa</creatorcontrib><creatorcontrib>Epceliden, M. Tuncay</creatorcontrib><creatorcontrib>Turgut, Nilda</creatorcontrib><creatorcontrib>Kale, Nilufer</creatorcontrib><creatorcontrib>Coban, Eda</creatorcontrib><creatorcontrib>Yesilot, Nilufer</creatorcontrib><creatorcontrib>Ekizoglu, Esme</creatorcontrib><creatorcontrib>Kizek, Ozgu</creatorcontrib><creatorcontrib>Bilgili, Ozlem</creatorcontrib><creatorcontrib>Baydemir, Recep</creatorcontrib><creatorcontrib>Akcakoyunlu, Merve</creatorcontrib><creatorcontrib>Yilmaz, Zahide</creatorcontrib><creatorcontrib>Ozturk, Serefnur</creatorcontrib><title>Atrial Fibrillation Management in Acute Stroke Patients in Turkiye: Real-life Data from the NoroTek Study/Turkiye'de Inme Hastalarinda Atrial Fibrilasyonun Yonetimi: NoroTek Calismasi Gercek? Hayat Verileri</title><title>Türk nöroloji dergisi</title><description>Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio [greater than or equal to]2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NoroTek (TR) revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known A F. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by A F. Keywords: Acute stroke, transient ischemic attack, anticoagulant, relapse, therapeutic dose, Holter monitoring Amac: Atrial fibrilasyon (AF) iskemik inmenin dogrudan onlenebilir en sik nedendir. Ulkemizde AF nedenli inme spektrumuna dair noroloji kaynakli genis olcekte bir veri bulunmamaktadir. NoroTek-Turkiye (TR) kapsaminda akut inme algoritmalarinin olusturulmasina katki yapmasi beklenen AF tespit edilen akut inme hastalarina dair hastane verisi toplanmistir. Gerec ve Yontem: 10 Mayis 2018 Dunya Inme Farkindalik Gunu'nde 30 saglik bolgesine yer alan 87 noroloji biriminde yatmakta olan 1.790 hasta prospektif olarak degerlendirilmistir. Calismada yer alan toplam 929 hasta [859 akut iskemik inme, 70 gecici iskemik atak (GIA)] bu analize dahil edilmistir. Bulgular: Iskemik inme/GIA sebebiyle ile interne edilmis hastalarda AF orani %29,8 olup bunlarin %65'i bilinmekte olan, %5'i paroksismal ve %30'u yeni tanidir. AF tanisi ile gelen hastalarda "etkin" tedavi [internasyonel normalizasyon orani [greater than or equal to]2,0 varfarin veya rehber dozunda non-vitamin K antagonist oral antikoagulan (NOAK)] alanlarin orani %25,3 olup, %42,5 olguda ya hic ilac kullanilmamakta ya da sadece antiplatelet kullanilmaktaydi. Dusuk doz kullanim orani 42 NOAK alirken inme gecirmis olguda %50 idi. Taburcu edilirken antikoagulan %94,6 (dusuk molekul agirlikli veya non-fraksiyone heparin %28,1; varfarin %32,5 ve NOAK %31) hastaya recete edilmisti. NOAK ile taburcu edilen olgularin %22'sinde doz dusuk kategoride olup geliste NOAK almakta olan olgularin yarisi ayni ilacla taburcu edilmistir. Sonuc: NoroTek (TR) ulkemizde AF'nin akut inmedeki sikligi yani sira sekonder proflaksi perspektifinde yonetiminin gelistirilebilecek yonlerini ortaya koydu. Turkiye'de hastanede yatan akut inme olgularinin yaklasik ucte birinde AF saptanmistir. AF'si bilinen akut inme olgularinin dortte ucunde etkin antikoagulan tedavi kullanilmamaktaydi. AF'de inme sekonder proflaksisi kapsaminda heparin, varfarin ve NOAK planlamasi benzer siklikta (ucte bir) olup recete edilen NOAK dozu dortte bir olguda subterapotiktir. AF'ye bagli inmenin onlenebilmesi non-medikal ve medikal egitim gerekli gorunmektedir. Anahtar Kelimeler: Akut inme, gecici iskemik atak, antikoagulan, nuks, terapotik doz, Holter monitorizasyon</description><subject>Apixaban</subject><subject>Atrial fibrillation</subject><subject>Clopidogrel</subject><subject>Ischemia</subject><subject>Stroke (Disease)</subject><subject>Stroke patients</subject><subject>Warfarin</subject><issn>1301-062X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNptUE1LAzEQ3YOCRb16HvDgaetust1sepFSPyr4hRbRk0w3kxqbzUKSHvon_U1GFFFwhmFg5r3Hm8myg7IYVkxUx9GpISsYH0pZSbaVDUpelHlRs6edbD-EtyIFl0LWfJC9T6I3aOHcLLyxFqPpHVyjwyV15CIYB5N2HQkeou9XBHcJkebhczFf-5XZ0BjuCW1ujSY4xYigfd9BfCW46X0_p1XirtXm-Bt-pAguXUcwwxDRojdOIfyxgWHTu7WD595RNJ0Z_yhN0ZrQYTBwQb6l1UlS2WCER0q0VHvZtkYbaP-772bz87P5dJZf3V5cTidX-bIWPFecSi0roURJ6Ue6qcSIIypJuFCsJp6mmuSo0E3dyrqsiGuGVdOwQjGBgu9mh1-yS7T0Ypzuo8e2M6F9mYi6EaOyrnhCDf9BpVTUmTbdppPn34QPQ6WNMA</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Topcuolu, Mehmet Akif</creator><creator>Arsava, Ethem Murat</creator><creator>Ozdemir, Atilla Ozcan</creator><creator>Aykac, Ozlem</creator><creator>Cetiner, Mustafa</creator><creator>Gencer, Elif Sarionder</creator><creator>Gunes, Aygul</creator><creator>Yaka, Erdem</creator><creator>Ocek, Levent</creator><creator>Tannverdi, Zeynep</creator><creator>Tekan, Ulgen Yalaz</creator><creator>Ozkan, Esra</creator><creator>Sirin, Hadiye</creator><creator>Guler, Ayse</creator><creator>Kursun, Oguzhan</creator><creator>Kunt, Refik</creator><creator>Cenikli, Utku</creator><creator>Acar, Bilgehan</creator><creator>Kablan, Yuksel</creator><creator>Isikay, Canan Togay</creator><creator>Aslanbaba, Eda</creator><creator>Sorgun, Mine</creator><creator>Bektas, Hesna</creator><creator>Cabalar, Murat</creator><creator>Yayla, Vildan</creator><creator>Erdogan, Haci Ali</creator><creator>Bavli, Songul</creator><creator>Ongun, Nedim</creator><creator>Keskin, Ahmet Onur</creator><creator>Akdoan, Ozlem</creator><creator>Emre, Ufuk</creator><creator>Yildiz, Ozlem Kayim</creator><creator>Bolayir, Asli</creator><creator>Karadeli, Hasan Huseyin</creator><creator>zel, Tugba</creator><creator>Unal, Ali</creator><creator>Dora, Babur</creator><creator>Arer, Zlfikar</creator><creator>Eren, Alper</creator><creator>Milanoglu, Aysel</creator><creator>Nazliel, Bijen</creator><creator>Caglayan, Hale Batur</creator><creator>Guven, Bulent</creator><creator>Erdogan, Mucahid</creator><creator>Acar, Zeynep OzdemirBakar, Mustafa</creator><creator>Senadim, Songul</creator><creator>Asil, Talip</creator><creator>Demir, Turgay</creator><creator>Unsal, Yaprak Ozum</creator><creator>Eskut, Neslihan</creator><creator>Bas, Demet Funda</creator><creator>Sener, Ufuk</creator><creator>Degirmenci, Bahar</creator><creator>Aluclu, Ufuk</creator><creator>Batan, Birgul</creator><creator>Acar, Zeynep</creator><creator>Niflioglu, Buket</creator><creator>Yazici, Duran</creator><creator>Aytac, Emrah</creator><creator>Ince, Fatma Birsen</creator><creator>Ay, Halil</creator><creator>Onder, Halil</creator><creator>Kozak, Hasan Huseyin</creator><creator>Ilgezdi, Irem</creator><creator>Bilgic, Adnan Burak</creator><creator>Akyol, Senol</creator><creator>Gungor, I. Levent</creator><creator>Atmaca, Murat Mert</creator><creator>Sen, Mustafa</creator><creator>Akkas, Sinem Yazici</creator><creator>Yolda, Tahir</creator><creator>Cinar, Bilge Piri</creator><creator>Yilmaz, Arda</creator><creator>Genc, Hamit</creator><creator>Kisabay, Aysin</creator><creator>Ilik, Faik</creator><creator>Demirbas, Hayri</creator><creator>Duman, Taskin</creator><creator>Demir, Tulin</creator><creator>Can, Ufuk</creator><creator>Yurekli, Vedat Ali</creator><creator>Bozdogan, Zehra</creator><creator>Kaya, Dilaver</creator><creator>Afsar, Nazire</creator><creator>Gurkas, Erdem</creator><creator>Toplutas, Eren</creator><creator>Degirmenci, Eylem</creator><creator>Aydn, Isa</creator><creator>Epceliden, M. Tuncay</creator><creator>Turgut, Nilda</creator><creator>Kale, Nilufer</creator><creator>Coban, Eda</creator><creator>Yesilot, Nilufer</creator><creator>Ekizoglu, Esme</creator><creator>Kizek, Ozgu</creator><creator>Bilgili, Ozlem</creator><creator>Baydemir, Recep</creator><creator>Akcakoyunlu, Merve</creator><creator>Yilmaz, Zahide</creator><creator>Ozturk, Serefnur</creator><general>Galenos Yayinevi Tic. Ltd</general><scope/></search><sort><creationdate>20230901</creationdate><title>Atrial Fibrillation Management in Acute Stroke Patients in Turkiye: Real-life Data from the NoroTek Study/Turkiye'de Inme Hastalarinda Atrial Fibrilasyonun Yonetimi: NoroTek Calismasi Gercek? Hayat Verileri</title><author>Topcuolu, Mehmet Akif ; Arsava, Ethem Murat ; Ozdemir, Atilla Ozcan ; Aykac, Ozlem ; Cetiner, Mustafa ; Gencer, Elif Sarionder ; Gunes, Aygul ; Yaka, Erdem ; Ocek, Levent ; Tannverdi, Zeynep ; Tekan, Ulgen Yalaz ; Ozkan, Esra ; Sirin, Hadiye ; Guler, Ayse ; Kursun, Oguzhan ; Kunt, Refik ; Cenikli, Utku ; Acar, Bilgehan ; Kablan, Yuksel ; Isikay, Canan Togay ; Aslanbaba, Eda ; Sorgun, Mine ; Bektas, Hesna ; Cabalar, Murat ; Yayla, Vildan ; Erdogan, Haci Ali ; Bavli, Songul ; Ongun, Nedim ; Keskin, Ahmet Onur ; Akdoan, Ozlem ; Emre, Ufuk ; Yildiz, Ozlem Kayim ; Bolayir, Asli ; Karadeli, Hasan Huseyin ; zel, Tugba ; Unal, Ali ; Dora, Babur ; Arer, Zlfikar ; Eren, Alper ; Milanoglu, Aysel ; Nazliel, Bijen ; Caglayan, Hale Batur ; Guven, Bulent ; Erdogan, Mucahid ; Acar, Zeynep OzdemirBakar, Mustafa ; Senadim, Songul ; Asil, Talip ; Demir, Turgay ; Unsal, Yaprak Ozum ; Eskut, Neslihan ; Bas, Demet Funda ; Sener, Ufuk ; Degirmenci, Bahar ; Aluclu, Ufuk ; Batan, Birgul ; Acar, Zeynep ; Niflioglu, Buket ; Yazici, Duran ; Aytac, Emrah ; Ince, Fatma Birsen ; Ay, Halil ; Onder, Halil ; Kozak, Hasan Huseyin ; Ilgezdi, Irem ; Bilgic, Adnan Burak ; Akyol, Senol ; Gungor, I. Levent ; Atmaca, Murat Mert ; Sen, Mustafa ; Akkas, Sinem Yazici ; Yolda, Tahir ; Cinar, Bilge Piri ; Yilmaz, Arda ; Genc, Hamit ; Kisabay, Aysin ; Ilik, Faik ; Demirbas, Hayri ; Duman, Taskin ; Demir, Tulin ; Can, Ufuk ; Yurekli, Vedat Ali ; Bozdogan, Zehra ; Kaya, Dilaver ; Afsar, Nazire ; Gurkas, Erdem ; Toplutas, Eren ; Degirmenci, Eylem ; Aydn, Isa ; Epceliden, M. Tuncay ; Turgut, Nilda ; Kale, Nilufer ; Coban, Eda ; Yesilot, Nilufer ; Ekizoglu, Esme ; Kizek, Ozgu ; Bilgili, Ozlem ; Baydemir, Recep ; Akcakoyunlu, Merve ; Yilmaz, Zahide ; Ozturk, Serefnur</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g673-d3e1f947d71e994f84753aad9eabd26e3e99fe950f86c9614e3f2a48820d27a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Apixaban</topic><topic>Atrial fibrillation</topic><topic>Clopidogrel</topic><topic>Ischemia</topic><topic>Stroke (Disease)</topic><topic>Stroke patients</topic><topic>Warfarin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Topcuolu, Mehmet Akif</creatorcontrib><creatorcontrib>Arsava, Ethem Murat</creatorcontrib><creatorcontrib>Ozdemir, Atilla Ozcan</creatorcontrib><creatorcontrib>Aykac, Ozlem</creatorcontrib><creatorcontrib>Cetiner, Mustafa</creatorcontrib><creatorcontrib>Gencer, Elif Sarionder</creatorcontrib><creatorcontrib>Gunes, Aygul</creatorcontrib><creatorcontrib>Yaka, Erdem</creatorcontrib><creatorcontrib>Ocek, Levent</creatorcontrib><creatorcontrib>Tannverdi, Zeynep</creatorcontrib><creatorcontrib>Tekan, Ulgen Yalaz</creatorcontrib><creatorcontrib>Ozkan, Esra</creatorcontrib><creatorcontrib>Sirin, Hadiye</creatorcontrib><creatorcontrib>Guler, Ayse</creatorcontrib><creatorcontrib>Kursun, Oguzhan</creatorcontrib><creatorcontrib>Kunt, Refik</creatorcontrib><creatorcontrib>Cenikli, Utku</creatorcontrib><creatorcontrib>Acar, Bilgehan</creatorcontrib><creatorcontrib>Kablan, Yuksel</creatorcontrib><creatorcontrib>Isikay, Canan Togay</creatorcontrib><creatorcontrib>Aslanbaba, Eda</creatorcontrib><creatorcontrib>Sorgun, Mine</creatorcontrib><creatorcontrib>Bektas, Hesna</creatorcontrib><creatorcontrib>Cabalar, Murat</creatorcontrib><creatorcontrib>Yayla, Vildan</creatorcontrib><creatorcontrib>Erdogan, Haci Ali</creatorcontrib><creatorcontrib>Bavli, Songul</creatorcontrib><creatorcontrib>Ongun, Nedim</creatorcontrib><creatorcontrib>Keskin, Ahmet Onur</creatorcontrib><creatorcontrib>Akdoan, Ozlem</creatorcontrib><creatorcontrib>Emre, Ufuk</creatorcontrib><creatorcontrib>Yildiz, Ozlem Kayim</creatorcontrib><creatorcontrib>Bolayir, Asli</creatorcontrib><creatorcontrib>Karadeli, Hasan Huseyin</creatorcontrib><creatorcontrib>zel, Tugba</creatorcontrib><creatorcontrib>Unal, Ali</creatorcontrib><creatorcontrib>Dora, Babur</creatorcontrib><creatorcontrib>Arer, Zlfikar</creatorcontrib><creatorcontrib>Eren, Alper</creatorcontrib><creatorcontrib>Milanoglu, Aysel</creatorcontrib><creatorcontrib>Nazliel, Bijen</creatorcontrib><creatorcontrib>Caglayan, Hale Batur</creatorcontrib><creatorcontrib>Guven, Bulent</creatorcontrib><creatorcontrib>Erdogan, Mucahid</creatorcontrib><creatorcontrib>Acar, Zeynep OzdemirBakar, Mustafa</creatorcontrib><creatorcontrib>Senadim, Songul</creatorcontrib><creatorcontrib>Asil, Talip</creatorcontrib><creatorcontrib>Demir, Turgay</creatorcontrib><creatorcontrib>Unsal, Yaprak Ozum</creatorcontrib><creatorcontrib>Eskut, Neslihan</creatorcontrib><creatorcontrib>Bas, Demet Funda</creatorcontrib><creatorcontrib>Sener, Ufuk</creatorcontrib><creatorcontrib>Degirmenci, Bahar</creatorcontrib><creatorcontrib>Aluclu, Ufuk</creatorcontrib><creatorcontrib>Batan, Birgul</creatorcontrib><creatorcontrib>Acar, Zeynep</creatorcontrib><creatorcontrib>Niflioglu, Buket</creatorcontrib><creatorcontrib>Yazici, Duran</creatorcontrib><creatorcontrib>Aytac, Emrah</creatorcontrib><creatorcontrib>Ince, Fatma Birsen</creatorcontrib><creatorcontrib>Ay, Halil</creatorcontrib><creatorcontrib>Onder, Halil</creatorcontrib><creatorcontrib>Kozak, Hasan Huseyin</creatorcontrib><creatorcontrib>Ilgezdi, Irem</creatorcontrib><creatorcontrib>Bilgic, Adnan Burak</creatorcontrib><creatorcontrib>Akyol, Senol</creatorcontrib><creatorcontrib>Gungor, I. Levent</creatorcontrib><creatorcontrib>Atmaca, Murat Mert</creatorcontrib><creatorcontrib>Sen, Mustafa</creatorcontrib><creatorcontrib>Akkas, Sinem Yazici</creatorcontrib><creatorcontrib>Yolda, Tahir</creatorcontrib><creatorcontrib>Cinar, Bilge Piri</creatorcontrib><creatorcontrib>Yilmaz, Arda</creatorcontrib><creatorcontrib>Genc, Hamit</creatorcontrib><creatorcontrib>Kisabay, Aysin</creatorcontrib><creatorcontrib>Ilik, Faik</creatorcontrib><creatorcontrib>Demirbas, Hayri</creatorcontrib><creatorcontrib>Duman, Taskin</creatorcontrib><creatorcontrib>Demir, Tulin</creatorcontrib><creatorcontrib>Can, Ufuk</creatorcontrib><creatorcontrib>Yurekli, Vedat Ali</creatorcontrib><creatorcontrib>Bozdogan, Zehra</creatorcontrib><creatorcontrib>Kaya, Dilaver</creatorcontrib><creatorcontrib>Afsar, Nazire</creatorcontrib><creatorcontrib>Gurkas, Erdem</creatorcontrib><creatorcontrib>Toplutas, Eren</creatorcontrib><creatorcontrib>Degirmenci, Eylem</creatorcontrib><creatorcontrib>Aydn, Isa</creatorcontrib><creatorcontrib>Epceliden, M. Tuncay</creatorcontrib><creatorcontrib>Turgut, Nilda</creatorcontrib><creatorcontrib>Kale, Nilufer</creatorcontrib><creatorcontrib>Coban, Eda</creatorcontrib><creatorcontrib>Yesilot, Nilufer</creatorcontrib><creatorcontrib>Ekizoglu, Esme</creatorcontrib><creatorcontrib>Kizek, Ozgu</creatorcontrib><creatorcontrib>Bilgili, Ozlem</creatorcontrib><creatorcontrib>Baydemir, Recep</creatorcontrib><creatorcontrib>Akcakoyunlu, Merve</creatorcontrib><creatorcontrib>Yilmaz, Zahide</creatorcontrib><creatorcontrib>Ozturk, Serefnur</creatorcontrib><jtitle>Türk nöroloji dergisi</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Topcuolu, Mehmet Akif</au><au>Arsava, Ethem Murat</au><au>Ozdemir, Atilla Ozcan</au><au>Aykac, Ozlem</au><au>Cetiner, Mustafa</au><au>Gencer, Elif Sarionder</au><au>Gunes, Aygul</au><au>Yaka, Erdem</au><au>Ocek, Levent</au><au>Tannverdi, Zeynep</au><au>Tekan, Ulgen Yalaz</au><au>Ozkan, Esra</au><au>Sirin, Hadiye</au><au>Guler, Ayse</au><au>Kursun, Oguzhan</au><au>Kunt, Refik</au><au>Cenikli, Utku</au><au>Acar, Bilgehan</au><au>Kablan, Yuksel</au><au>Isikay, Canan Togay</au><au>Aslanbaba, Eda</au><au>Sorgun, Mine</au><au>Bektas, Hesna</au><au>Cabalar, Murat</au><au>Yayla, Vildan</au><au>Erdogan, Haci Ali</au><au>Bavli, Songul</au><au>Ongun, Nedim</au><au>Keskin, Ahmet Onur</au><au>Akdoan, Ozlem</au><au>Emre, Ufuk</au><au>Yildiz, Ozlem Kayim</au><au>Bolayir, Asli</au><au>Karadeli, Hasan Huseyin</au><au>zel, Tugba</au><au>Unal, Ali</au><au>Dora, Babur</au><au>Arer, Zlfikar</au><au>Eren, Alper</au><au>Milanoglu, Aysel</au><au>Nazliel, Bijen</au><au>Caglayan, Hale Batur</au><au>Guven, Bulent</au><au>Erdogan, Mucahid</au><au>Acar, Zeynep OzdemirBakar, Mustafa</au><au>Senadim, Songul</au><au>Asil, Talip</au><au>Demir, Turgay</au><au>Unsal, Yaprak Ozum</au><au>Eskut, Neslihan</au><au>Bas, Demet Funda</au><au>Sener, Ufuk</au><au>Degirmenci, Bahar</au><au>Aluclu, Ufuk</au><au>Batan, Birgul</au><au>Acar, Zeynep</au><au>Niflioglu, Buket</au><au>Yazici, Duran</au><au>Aytac, Emrah</au><au>Ince, Fatma Birsen</au><au>Ay, Halil</au><au>Onder, Halil</au><au>Kozak, Hasan Huseyin</au><au>Ilgezdi, Irem</au><au>Bilgic, Adnan Burak</au><au>Akyol, Senol</au><au>Gungor, I. Levent</au><au>Atmaca, Murat Mert</au><au>Sen, Mustafa</au><au>Akkas, Sinem Yazici</au><au>Yolda, Tahir</au><au>Cinar, Bilge Piri</au><au>Yilmaz, Arda</au><au>Genc, Hamit</au><au>Kisabay, Aysin</au><au>Ilik, Faik</au><au>Demirbas, Hayri</au><au>Duman, Taskin</au><au>Demir, Tulin</au><au>Can, Ufuk</au><au>Yurekli, Vedat Ali</au><au>Bozdogan, Zehra</au><au>Kaya, Dilaver</au><au>Afsar, Nazire</au><au>Gurkas, Erdem</au><au>Toplutas, Eren</au><au>Degirmenci, Eylem</au><au>Aydn, Isa</au><au>Epceliden, M. Tuncay</au><au>Turgut, Nilda</au><au>Kale, Nilufer</au><au>Coban, Eda</au><au>Yesilot, Nilufer</au><au>Ekizoglu, Esme</au><au>Kizek, Ozgu</au><au>Bilgili, Ozlem</au><au>Baydemir, Recep</au><au>Akcakoyunlu, Merve</au><au>Yilmaz, Zahide</au><au>Ozturk, Serefnur</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial Fibrillation Management in Acute Stroke Patients in Turkiye: Real-life Data from the NoroTek Study/Turkiye'de Inme Hastalarinda Atrial Fibrilasyonun Yonetimi: NoroTek Calismasi Gercek? Hayat Verileri</atitle><jtitle>Türk nöroloji dergisi</jtitle><date>2023-09-01</date><risdate>2023</risdate><volume>29</volume><issue>3</issue><spage>183</spage><pages>183-</pages><issn>1301-062X</issn><abstract>Objective: Atrial fibrillation (AF) is the most common directly preventable cause of ischemic stroke. There is no dependable neurology-based data on the spectrum of stroke caused by AF in Turkiye. Within the scope of NoroTek-Turkiye (TR), hospital-based data on acute stroke patients with AF were collected to contribute to the creation of acute-stroke algorithms. Materials and Methods: On May 10, 2018 (World Stroke Awareness Day), 1,790 patients hospitalized at 87 neurology units in 30 health regions were prospectively evaluated. A total of 929 patients [859 acute ischemic stroke, 70 transient ischemic attack (TIA)] from this study were included in this analysis. Results: The rate of AF in patients hospitalized for ischemic stroke/TIA was 29.8%, of which 65% were known before stroke, 5% were paroxysmal, and 30% were diagnosed after hospital admission. The proportion of patients with AF who received "effective" treatment [international normalization ratio [greater than or equal to]2.0 warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) at a guideline dose] was 25.3%, and, either no medication or only antiplatelet was used in 42.5% of the cases. The low dose rate was 50% in 42 patients who had a stroke while taking NOACs. Anticoagulant was prescribed to the patient at discharge at a rate of 94.6%; low molecular weight or unfractionated heparin was prescribed in 28.1%, warfarin in 32.5%, and NOACs in 31%. The dose was in the low category in 22% of the cases discharged with NOACs, and half of the cases, who received NOACs at admission, were discharged with the same drug. Conclusion: NoroTek (TR) revealed the high but expected frequency of AF in acute stroke in Turkiye, as well as the aspects that could be improved in the management of secondary prophylaxis. AF is found in approximately one-third of hospitalized acute stroke cases in Turkiye. Effective anticoagulant therapy was not used in three-quarters of acute stroke cases with known A F. In AF, heparin, warfarin, and NOACs are planned at a similar frequency (one-third) within the scope of stroke secondary prophylaxis, and the prescribed NOAC dose is subtherapeutic in a quarter of the cases. Non-medical and medical education appears necessary to prevent stroke caused by A F. Keywords: Acute stroke, transient ischemic attack, anticoagulant, relapse, therapeutic dose, Holter monitoring Amac: Atrial fibrilasyon (AF) iskemik inmenin dogrudan onlenebilir en sik nedendir. Ulkemizde AF nedenli inme spektrumuna dair noroloji kaynakli genis olcekte bir veri bulunmamaktadir. NoroTek-Turkiye (TR) kapsaminda akut inme algoritmalarinin olusturulmasina katki yapmasi beklenen AF tespit edilen akut inme hastalarina dair hastane verisi toplanmistir. Gerec ve Yontem: 10 Mayis 2018 Dunya Inme Farkindalik Gunu'nde 30 saglik bolgesine yer alan 87 noroloji biriminde yatmakta olan 1.790 hasta prospektif olarak degerlendirilmistir. Calismada yer alan toplam 929 hasta [859 akut iskemik inme, 70 gecici iskemik atak (GIA)] bu analize dahil edilmistir. Bulgular: Iskemik inme/GIA sebebiyle ile interne edilmis hastalarda AF orani %29,8 olup bunlarin %65'i bilinmekte olan, %5'i paroksismal ve %30'u yeni tanidir. AF tanisi ile gelen hastalarda "etkin" tedavi [internasyonel normalizasyon orani [greater than or equal to]2,0 varfarin veya rehber dozunda non-vitamin K antagonist oral antikoagulan (NOAK)] alanlarin orani %25,3 olup, %42,5 olguda ya hic ilac kullanilmamakta ya da sadece antiplatelet kullanilmaktaydi. Dusuk doz kullanim orani 42 NOAK alirken inme gecirmis olguda %50 idi. Taburcu edilirken antikoagulan %94,6 (dusuk molekul agirlikli veya non-fraksiyone heparin %28,1; varfarin %32,5 ve NOAK %31) hastaya recete edilmisti. NOAK ile taburcu edilen olgularin %22'sinde doz dusuk kategoride olup geliste NOAK almakta olan olgularin yarisi ayni ilacla taburcu edilmistir. Sonuc: NoroTek (TR) ulkemizde AF'nin akut inmedeki sikligi yani sira sekonder proflaksi perspektifinde yonetiminin gelistirilebilecek yonlerini ortaya koydu. Turkiye'de hastanede yatan akut inme olgularinin yaklasik ucte birinde AF saptanmistir. AF'si bilinen akut inme olgularinin dortte ucunde etkin antikoagulan tedavi kullanilmamaktaydi. AF'de inme sekonder proflaksisi kapsaminda heparin, varfarin ve NOAK planlamasi benzer siklikta (ucte bir) olup recete edilen NOAK dozu dortte bir olguda subterapotiktir. AF'ye bagli inmenin onlenebilmesi non-medikal ve medikal egitim gerekli gorunmektedir. Anahtar Kelimeler: Akut inme, gecici iskemik atak, antikoagulan, nuks, terapotik doz, Holter monitorizasyon</abstract><pub>Galenos Yayinevi Tic. Ltd</pub><doi>10.4274/tnd.2023.99492</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1301-062X |
| ispartof | Türk nöroloji dergisi, 2023-09, Vol.29 (3), p.183 |
| issn | 1301-062X |
| language | eng |
| recordid | cdi_gale_infotracmisc_A768751643 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Apixaban Atrial fibrillation Clopidogrel Ischemia Stroke (Disease) Stroke patients Warfarin |
| title | Atrial Fibrillation Management in Acute Stroke Patients in Turkiye: Real-life Data from the NoroTek Study/Turkiye'de Inme Hastalarinda Atrial Fibrilasyonun Yonetimi: NoroTek Calismasi Gercek? Hayat Verileri |
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