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Analysis of geographical variations in the epidemiology and management of non-valvular atrial fibrillation: results from the RAMSES registry [Anatol J Cardiol]
Anatol J Cardiol. 2017; 18(4): 273-280 | DOI: 10.14744/AnatolJCardiol.2017.7709  

Analysis of geographical variations in the epidemiology and management of non-valvular atrial fibrillation: results from the RAMSES registry

Volkan Doğan1, Özcan Başaran1, Murat Biteker1, Fatma Özpamuk Karadeniz2, Ahmet İlker Tekkesin3, Yasin Çakıllı4, Ceyhan Türkkan3, Mehmet Hamidi5, Vahit Demir6, Mustafa Ozan Gürsoy7, Müjgan Tek Öztürk8, Gökhan Aksan9, Sabri Seyis10, Mehmet Ballı11, Mehmet Hayri Alıcı12, Serdar Bozyel13, Cevat Kırma14, And Collaborators
1Department of Cardiology, Faculty of Medicine, Muğla Sıtkı Kocman University; Muğla-Turkey
2Department of Cardiology, Şanlıurfa Balıklıgöl State Hospital; Şanlıurfa- Turkey
3Department of Cardiology, Siyami Ersek Heart Education and Research Hospital; İstanbul- Turkey
4Department of Cardiology, Tuzla State Hospital; İstanbul-Turkey
5Department of Cardiology, Bandırma State Hospital; Balıkesir-Turkey
6Department of Cardiology, Yozgat State Hospital; Yozgat-Turkey
7Department of Cardiology, Gaziemir State Hospital; İzmir-Turkey
8Department of Cardiology, Ankara Keçiören Education and Research Hospital; Ankara-Turkey
9Department of Cardiology, Şişli Hamidiye Etfal Education and Research Hospital; İstanbul- Turkey
10Department of Cardiology, Mersin Private Doğuş Hospital; Mersin-Turkey
11Department of Cardiology, Mersin Toros State Hospital; Mersin-Turkey
12Department of Cardiology, Gaziantep 25 Aralık State Hospital; Gaziantep-Turkey
13Department of Cardiology, Kocaeli Derince Education and Research Hospital; Kocaeli- Turkey
14Department of Cardiology, Kartal Koşuyolu Heart Education and Research Hospital; İstanbul-Turkey

Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.

Keywords: epidemiology, chronic disease, anticoagulant therapy

Volkan Doğan, Özcan Başaran, Murat Biteker, 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, Cevat Kırma, And Collaborators. Analysis of geographical variations in the epidemiology and management of non-valvular atrial fibrillation: results from the RAMSES registry. Anatol J Cardiol. 2017; 18(4): 273-280

Corresponding Author: Volkan Doğan, Türkiye

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