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Coronary artery disease in outpatients with nonvalvular atrial fibrillation: results from the multicenter RAMSES

Volkan Dogan1, Özcan Başaran, Osman Beton

  • 1aDepartment of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla bDepartment of Cardiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas cDepartment of Cardiology, Kahramanmaraş Necip Fazil State Hospital, Kahramanmaras dDepartment of Cardiology, Fethiye State Hospital, Fethiye eDepartment of Cardiology, Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon fDepartment of Cardiology, Elaziğ Education and Research Hospital, Elazig gDepartment of Cardiology, Burdur State Hospital, Burdur hDepartment of Cardiology, İskilip Atif Hoca State Hospital, Iskilip iDepartment of Cardiology, Samsun Education and Research Hospital, Samsun jKartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey.

Coronary Artery Disease
|May 17, 2016
PubMed

Insights

Coronary artery disease (CAD) affects nearly one-third of patients with nonvalvular atrial fibrillation (NVAF). Despite higher stroke risk, these patients receive less oral anticoagulant therapy.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Nonvalvular atrial fibrillation (NVAF) often coexists with coronary artery disease (CAD).
  • Optimal antithrombotic strategies for patients with both conditions remain controversial.
  • Assessing CAD prevalence in NVAF patients and their treatment patterns is crucial.

Purpose of the Study:

  • To determine the prevalence of CAD in a large cohort of NVAF patients.
  • To compare antithrombotic treatment strategies in NVAF patients with and without CAD.
  • To identify disparities in oral anticoagulant (OAC) and antiplatelet therapy use.

Main Methods:

  • The ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey (RAMSES) study utilized cross-sectional, nationwide observational data.
  • Clinical data from 6264 NVAF patients were analyzed.
  • Demographic characteristics and antithrombotic therapies were compared between patients with and without CAD.

Main Results:

  • CAD was identified in 29.2% of NVAF patients.
  • Patients with CAD had higher CHA2DS2VASc scores but received OAC therapy less frequently (66.1% vs. 74.4%).
  • CAD patients were prescribed warfarin more often, while non-vitamin K antagonist oral anticoagulants were preferred in non-CAD patients. Antiplatelet use was significantly higher in CAD patients (57.8% vs. 21.4%).

Conclusions:

  • CAD is prevalent in nearly one-third of NVAF patients in a real-world setting.
  • Despite higher risk, NVAF patients with CAD are undertreated with OAC therapy.
  • Current antithrombotic strategies may not adequately address the complex needs of NVAF patients with concomitant CAD.
Abstract

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