Doğan Volkan, Başaran Özcan, Biteker Murat, Özpamuk Karadeniz Fatma, Tekkesin Ahmet İlker, Çakıllı Yasin, Türkkan Ceyhan, Hamidi Mehmet, Demir Vahit, Gürsoy Mustafa Ozan, Tek Öztürk Müjgan, Aksan Gökhan, Seyis Sabri, Ballı Mehmet, Alıcı Mehmet Hayri, Bozyel Serdar, Kırma Cevat
Department of Cardiology, Faculty of Medicine, Muğla Sıtkı Kocman University; Muğla-Turkey.
Anatol J Cardiol. 2017 Oct;18(4):273-280. doi: 10.14744/AnatolJCardiol.2017.7709. Epub 2017 Aug 11.
This study aimed to determine the differences in terms of demographic characteristics and preferred stroke prevention strategies for patients with non-valvular atrial fibrillation living in seven geographical regions of Turkey.
In total, 6273 patients were enrolled to this prospective, observational RAMSES study. The patients were divided into seven groups based on the geographical region of residence.
In terms of the geographical distribution of the overall Turkish population, the highest number of patients were enrolled from Marmara (1677, 26.7%). All demographic characteristics were significantly different among regions. Preferred oral anticoagulants (OACs) also differed between geographical regions; non-vitamin K OACs were preceded by warfarin in East Anatolia, Aegean, Southeast Anatolia, and Black Sea. Nearly one-third of the patients (28%) did not receive any OAC therapy. However, the number of patients not receiving any OAC therapy was higher in Southeast Anatolia (51.1%) and East Anatolia (46.8%) compared with other geographical regions of Turkey. Inappropriate use of OACs was also more common in East and Southeast Anatolia.
This study was the first to show that the demographic differences among the geographical regions may result in different preferences of stroke prevention strategies in Turkey. OACs are still under- or inappropriately utilized, particularly in the eastern provinces of Turkey.
本研究旨在确定居住在土耳其七个地理区域的非瓣膜性心房颤动患者在人口统计学特征和首选的卒中预防策略方面的差异。
共有6273名患者纳入了这项前瞻性观察性RAMSES研究。根据居住的地理区域将患者分为七组。
就土耳其总人口的地理分布而言，来自马尔马拉地区的患者人数最多（1677人，占26.7%）。各地区之间所有人口统计学特征均存在显著差异。不同地理区域首选的口服抗凝剂（OAC）也有所不同；在东安纳托利亚、爱琴海、东南安纳托利亚和黑海地区，维生素K拮抗剂之前使用的是华法林。近三分之一的患者（28%）未接受任何OAC治疗。然而，与土耳其其他地理区域相比，东南安纳托利亚（51.1%）和东安纳托利亚（46.8%）未接受任何OAC治疗的患者人数更多。OAC的不当使用在东安纳托利亚和东南安纳托利亚也更为常见。
本研究首次表明，土耳其不同地理区域之间的人口统计学差异可能导致卒中预防策略的不同偏好。OAC的使用仍然不足或存在不当情况，尤其是在土耳其东部省份。
