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  • Küçük Resim
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    Safety of once-or twice-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with nonvalvular atrial fibrillation: a NOAC-TR study
    (Association of Basic Medical Sciences of FBIH, 2018) Emren, Sadık Volkan; Zoghi, Mehdi; Berilgen, Rida; Özdemir, İbrahim Halil; Çelik, Oğuzhan; Çetin, Nurullah; Enhoş, Asım; Köseoğlu, Cemal; Akyüz, Abdurrahman; Doğan, Volkan; Levent, Fatih; Dereli, Yüksel; Doğan, Tolga; Başaran, Özcan; Karaca, Ilgın; Karaca, Özkan; Otlu, Yılmaz Ömür; Özmen, Çağlar; Coşar, Selvi; Sümerkan, Mutlu Çağan; Gürsul, Erdal; İnci, Sinan; Onrat, Ersel; Ergene, Oktay
    Once-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) may increase patient adherence to treatment but may also be associated with a higher risk of bleeding. In this study, we investigated the adherence to once-or twice-daily dosing of NOACs and the risk of bleeding in nonvalvular atrial fibrillation (NVAF) patients. This multicenter cross-sectional study, conducted between 1 September 2015 and 28 February 2016, included 2214 patients receiving NOACs for at least 3 months, due to NVAF. Patients receiving once-daily or twice-daily NOAC doses were 1:1 propensity score matched for baseline demographic characteristics and the presence of other diseases. The medication adherence was assessed by the 8-item Morisky Medication Adherence Scale. Risk factors were investigated in relation to minor and major bleeding. The mean age of patients was 71 ± 10 years, and 53% of the patients were women. The medication adherence was lower in patients receiving twice-daily NOAC doses compared to once-daily-dose group (47% versus 53%, p = 0.001), and there was no difference between the groups in terms of minor (15% versus 16%, p = 0.292) and major bleeding (3% versus 3%, p = 0.796). Independent risk factors for bleeding were non-adherence to medication (OR: 1.62, 95% CI: 1.23–2.14, p = 0.001), presence of 3 or more other diseases (OR: 10.3, 95% CI: 5.3–20.3, p < 0.001), and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol) score (OR: 4.84, 95% CI: 4.04–5.8, p < 0.001). In summary, the once-daily dose of NOACs was associated with increased patient adherence to medication, while it was not associated with bleeding complications. © 2018 ABMSFBIH.
  • Küçük Resim
    Öğe
    Secondary prevention of coronary heart disease in elderly population of turkey: A subgroup analysis of Elderturk study
    (Via Medica, 2019) Kılıç, Salih; Sümerkan, Mutlu Çağan; Emren, Sadık Volkan; Bekar, Lütfü; Çerşit, Sinan; Tunç, Elif; Gök, Gülay; Altuntaş, Emine; Canpolat, Uğur; Sinan, Ümit Yaşar; Özmen, Namık; Zoghi, Mehdi
    Background: Secondary prevention plays an important role after acute coronary event due to high risk of adverse events in elderly. In present study we aimed to evaluate the lifestyle, management of risk factors and medical treatment for secondary protection in elderly patients with known coronary heart disease (CHD). Methods: ELDERTURK is a non-interventional, multi-centered, observational study, which included total of 5694 elderly patients (> 65 years) from 50 centers in Turkey. In this study elderly patients from the ELDERTURK population with known CHD were evaluated for cardiovascular risk factors, comorbidities and medication usage. Results: A total of 2976 (52.3% of study) out of 5694 patients included in the ELDERTURK study were evaluated. All had known CHD with a mean age of 73.4 ± 6.2 years and 60.3% were male. 13.0% of patients were smokers, 42.4% were overweight and 21.1% were obese. Only 23.6% of patients reported to do regular exercise, 73.4% had history of hypertension, 47.4% had dyslipidemia and 33.9% had diabetes mellitus. The rate of patients with systolic blood pressure > 140 mmHg were 31.1% and only 13.9% of patients had a recommended ? 70 mg/dL level of low-density lipoprotein cholesterol. Antiplatelet, statin, beta-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker usage was limited to 27.3%. Conclusions: The ELDERTURK study shows that many patients with CHD have a high prevalence of modifiable risk factors and unhealthy lifestyle. Apart from this, many patients are not receiving therapeutic intervention and as a consequence most were not achieving the recommended goals. © 2019 Via Medica.