Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry

Erküner; M. van Eck; O. Xhaet; H. Verheij; J. Neefs; A. Duygun; R. Nijmeijer; S. A. M. Saïd; H. Uiterwaal; V. Hagens; R. Bhagwandien; T. Szili-Torok; N. Bijsterveld; G. Tjeerdsma; J. Vijgen; A. Friart; E. Hoffer; P. Evrard; M. Srynger; J. Meeder; J. R. de Groot; J. van Opstal; R. Gevers; G. Y. H. Lip; G. Boriani; H. J. G. M. Crijns; J. G. L. M. Luermans; G. H. Mairesse

doi:10.1007/s12471-021-01634-y

Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry

Erküner^*
, M. van Eck
, O. Xhaet
, H. Verheij
, J. Neefs
, A. Duygun
, R. Nijmeijer
, S. A. M. Saïd
, H. Uiterwaal
, V. Hagens
, R. Bhagwandien
, T. Szili-Torok
, N. Bijsterveld
, G. Tjeerdsma
, J. Vijgen
, A. Friart
, E. Hoffer
, P. Evrard
, M. Srynger
, J. Meeder

J. R. de Groot, J. van Opstal, R. Gevers, G. Y. H. Lip, G. Boriani, H. J. G. M. Crijns, J. G. L. M. Luermans, G. H. Mairesse

^*Corresponding author for this work

Maastricht UMC+
Maastricht University
Jeroen Bosch Ziekenhuis
Department of Cardiology, CHU Namur, Yvoir, Belgium
Medisch Spectrum Twente
Amsterdam UMC - University of Amsterdam
VieCuri Medisch Centrum
Department of Cardiology, Tjongerschans Hospital, Heerenveen, The Netherlands
Department of Paediatrics, Netherlands
Flevo Hospital
Department of Cardiology, Ommelander Hospital Group, Delfzijl, The Netherlands
Erasmus MC
ENT department, Jessa hospital, Hasselt, Belgium
Université libre de Bruxelles
Intensive Care Unit, CHR Citadelle, Liège, Belgium
Department of Cardiology, CHC St Joseph, Liège, Belgium
University of Liege
University of Birmingham
Aalborg University
University of Modena and Reggio Emilia
Arlon and Clinique Ste Thérèse, Department of Cardiology, Cliniques du Sud-Luxembourg, Bastogne, Belgium

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Contemporary data regarding the characteristics, treatment and outcomes of patients with atrial fibrillation (AF) are needed. We aimed to assess these data and guideline adherence in the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) long-term general registry. Methods: We analysed 967 patients from the EORP-AF long-term general registry included in the Netherlands and Belgium from 2013 to 2016. Baseline and 1‑year follow-up data were gathered. Results: At baseline, 887 patients (92%) received anticoagulant treatment. In 88 (10%) of these patients, no indication for chronic anticoagulant treatment was present. A rhythm intervention was performed or planned in 52 of these patients, meaning that the remaining 36 (41%) were anticoagulated without indication. Forty patients were not anticoagulated, even though they had an indication for chronic anticoagulation. Additionally, 63 of the 371 patients (17%) treated with a non-vitamin K antagonist oral anticoagulant (NOAC) were incorrectly dosed. In total, 50 patients (5%) were overtreated and 89 patients (9%) were undertreated. However, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was still low with 4.2% (37 patients). Conclusions: Overtreatment and undertreatment with anticoagulants are still observable in 14% of this contemporary, West-European AF population. Still, MACCE occurred in only 4% of the patients after 1 year of follow-up.

Original language	English
Pages (from-to)	584-594
Number of pages	11
Journal	Netherlands heart journal
Volume	29
Issue number	11
Early online date	2021
DOIs	https://doi.org/10.1007/s12471-021-01634-y
Publication status	Published - Nov 2021

Keywords

Anticoagulant
Atrial fibrillation
EORP
Overtreatment
Registry
Undertreatment

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Erküner, van Eck, M., Xhaet, O., Verheij, H., Neefs, J., Duygun, A., Nijmeijer, R., Saïd, S. A. M., Uiterwaal, H., Hagens, V., Bhagwandien, R., Szili-Torok, T., Bijsterveld, N., Tjeerdsma, G., Vijgen, J., Friart, A., Hoffer, E., Evrard, P., Srynger, M., ... Mairesse, G. H. (2021). Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry. Netherlands heart journal, 29(11), 584-594. https://doi.org/10.1007/s12471-021-01634-y

@article{ce93a74cc8f649d2abf95e0a4fe77454,

title = "Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry",

abstract = "Background: Contemporary data regarding the characteristics, treatment and outcomes of patients with atrial fibrillation (AF) are needed. We aimed to assess these data and guideline adherence in the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) long-term general registry. Methods: We analysed 967 patients from the EORP-AF long-term general registry included in the Netherlands and Belgium from 2013 to 2016. Baseline and 1‑year follow-up data were gathered. Results: At baseline, 887 patients (92\%) received anticoagulant treatment. In 88 (10\%) of these patients, no indication for chronic anticoagulant treatment was present. A rhythm intervention was performed or planned in 52 of these patients, meaning that the remaining 36 (41\%) were anticoagulated without indication. Forty patients were not anticoagulated, even though they had an indication for chronic anticoagulation. Additionally, 63 of the 371 patients (17\%) treated with a non-vitamin K antagonist oral anticoagulant (NOAC) were incorrectly dosed. In total, 50 patients (5\%) were overtreated and 89 patients (9\%) were undertreated. However, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was still low with 4.2\% (37 patients). Conclusions: Overtreatment and undertreatment with anticoagulants are still observable in 14\% of this contemporary, West-European AF population. Still, MACCE occurred in only 4\% of the patients after 1 year of follow-up.",

keywords = "Anticoagulant, Atrial fibrillation, EORP, Overtreatment, Registry, Undertreatment",

author = "Erk{\"u}ner and \{van Eck\}, M. and O. Xhaet and H. Verheij and J. Neefs and A. Duygun and R. Nijmeijer and Sa{\"i}d, \{S. A. M.\} and H. Uiterwaal and V. Hagens and R. Bhagwandien and T. Szili-Torok and N. Bijsterveld and G. Tjeerdsma and J. Vijgen and A. Friart and E. Hoffer and P. Evrard and M. Srynger and J. Meeder and \{de Groot\}, \{J. R.\} and \{van Opstal\}, J. and R. Gevers and Lip, \{G. Y. H.\} and G. Boriani and Crijns, \{H. J. G. M.\} and Luermans, \{J. G. L. M.\} and Mairesse, \{G. H.\}",

note = "Funding Information: We are grateful to all participating centres, investigators, and data collection officers for performing the registry. Data collection was conducted by the EURObservational Research Programme department from the European Cardiac Society by Patti-Ann McNeill as project officer and by Viviane Missiamenou as data manager. Overall activities were coordinated by Dr Aldo?P.?Maggioni (EORP Scientific Coordinator). We are very grateful to the alliance of Bristol-Myers Squibb and Pfizer for their financial support in performing the EORP-AF Long-Term General Registry in both the Netherlands and Belgium. The sponsor was not involved in the preparation or publication of this manuscript. The EURObservational Research Programme is supported by the following companies: Abbott Vascular Int. (2011?2014), Amgen Cardiovascular (2009?2018), AstraZeneca (2014?2017), Bayer AG (2009?2018), Boehringer Ingelheim (2009?2019), Boston Scientific (2009?2012), The Bristol Myers Squibb and Pfizer Alliance (2011?2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011?2017), Edwards (2016?2019), Gedeon Richter Plc. (2014?2017), Menarini Int. Op. (2009?2012), MSD-Merck \& Co. (2011?2014), Novartis Pharma AG (2014?2017), ResMed (2014?2016), Sanofi (2009?2011), and SERVIER (2009?2018). This work was supported by the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation [CVON 2014?9, RACE?V: ?Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling, and Vascular destabilisation in the progression of AF? to ?.E., H.J.G.M.C., J.G.L.M.L]. Funding Information: The EURObservational Research Programme is supported by the following companies: Abbott Vascular Int. (2011–2014), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2017), Bayer AG (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck \& Co. (2011–2014), Novartis Pharma AG (2014–2017), ResMed (2014–2016), Sanofi (2009–2011), and SERVIER (2009–2018). Funding Information: We are very grateful to the alliance of Bristol-Myers Squibb and Pfizer for their financial support in performing the EORP-AF Long-Term General Registry in both the Netherlands and Belgium. The sponsor was not involved in the preparation or publication of this manuscript. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = nov,

doi = "10.1007/s12471-021-01634-y",

language = "English",

volume = "29",

pages = "584--594",

journal = "Netherlands heart journal",

issn = "1568-5888",

publisher = "Bohn Stafleu Van Loghum",

number = "11",

}

Erküner, van Eck, M, Xhaet, O, Verheij, H, Neefs, J, Duygun, A, Nijmeijer, R, Saïd, SAM, Uiterwaal, H, Hagens, V, Bhagwandien, R, Szili-Torok, T, Bijsterveld, N, Tjeerdsma, G, Vijgen, J, Friart, A, Hoffer, E, Evrard, P, Srynger, M, Meeder, J, de Groot, JR, van Opstal, J, Gevers, R, Lip, GYH, Boriani, G, Crijns, HJGM, Luermans, JGLM & Mairesse, GH 2021, 'Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry', Netherlands heart journal, vol. 29, no. 11, pp. 584-594. https://doi.org/10.1007/s12471-021-01634-y

TY - JOUR

T1 - Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry

AU - Erküner, null

AU - van Eck, M.

AU - Xhaet, O.

AU - Verheij, H.

AU - Neefs, J.

AU - Duygun, A.

AU - Nijmeijer, R.

AU - Saïd, S. A. M.

AU - Uiterwaal, H.

AU - Hagens, V.

AU - Bhagwandien, R.

AU - Szili-Torok, T.

AU - Bijsterveld, N.

AU - Tjeerdsma, G.

AU - Vijgen, J.

AU - Friart, A.

AU - Hoffer, E.

AU - Evrard, P.

AU - Srynger, M.

AU - Meeder, J.

AU - de Groot, J. R.

AU - van Opstal, J.

AU - Gevers, R.

AU - Lip, G. Y. H.

AU - Boriani, G.

AU - Crijns, H. J. G. M.

AU - Luermans, J. G. L. M.

AU - Mairesse, G. H.

N1 - Funding Information: We are grateful to all participating centres, investigators, and data collection officers for performing the registry. Data collection was conducted by the EURObservational Research Programme department from the European Cardiac Society by Patti-Ann McNeill as project officer and by Viviane Missiamenou as data manager. Overall activities were coordinated by Dr Aldo?P.?Maggioni (EORP Scientific Coordinator). We are very grateful to the alliance of Bristol-Myers Squibb and Pfizer for their financial support in performing the EORP-AF Long-Term General Registry in both the Netherlands and Belgium. The sponsor was not involved in the preparation or publication of this manuscript. The EURObservational Research Programme is supported by the following companies: Abbott Vascular Int. (2011?2014), Amgen Cardiovascular (2009?2018), AstraZeneca (2014?2017), Bayer AG (2009?2018), Boehringer Ingelheim (2009?2019), Boston Scientific (2009?2012), The Bristol Myers Squibb and Pfizer Alliance (2011?2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011?2017), Edwards (2016?2019), Gedeon Richter Plc. (2014?2017), Menarini Int. Op. (2009?2012), MSD-Merck & Co. (2011?2014), Novartis Pharma AG (2014?2017), ResMed (2014?2016), Sanofi (2009?2011), and SERVIER (2009?2018). This work was supported by the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation [CVON 2014?9, RACE?V: ?Reappraisal of Atrial Fibrillation: interaction between hyperCoagulability, Electrical remodelling, and Vascular destabilisation in the progression of AF? to ?.E., H.J.G.M.C., J.G.L.M.L]. Funding Information: The EURObservational Research Programme is supported by the following companies: Abbott Vascular Int. (2011–2014), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2017), Bayer AG (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Edwards (2016–2019), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2017), ResMed (2014–2016), Sanofi (2009–2011), and SERVIER (2009–2018). Funding Information: We are very grateful to the alliance of Bristol-Myers Squibb and Pfizer for their financial support in performing the EORP-AF Long-Term General Registry in both the Netherlands and Belgium. The sponsor was not involved in the preparation or publication of this manuscript. Publisher Copyright: © 2021, The Author(s).

PY - 2021/11

Y1 - 2021/11

N2 - Background: Contemporary data regarding the characteristics, treatment and outcomes of patients with atrial fibrillation (AF) are needed. We aimed to assess these data and guideline adherence in the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) long-term general registry. Methods: We analysed 967 patients from the EORP-AF long-term general registry included in the Netherlands and Belgium from 2013 to 2016. Baseline and 1‑year follow-up data were gathered. Results: At baseline, 887 patients (92%) received anticoagulant treatment. In 88 (10%) of these patients, no indication for chronic anticoagulant treatment was present. A rhythm intervention was performed or planned in 52 of these patients, meaning that the remaining 36 (41%) were anticoagulated without indication. Forty patients were not anticoagulated, even though they had an indication for chronic anticoagulation. Additionally, 63 of the 371 patients (17%) treated with a non-vitamin K antagonist oral anticoagulant (NOAC) were incorrectly dosed. In total, 50 patients (5%) were overtreated and 89 patients (9%) were undertreated. However, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was still low with 4.2% (37 patients). Conclusions: Overtreatment and undertreatment with anticoagulants are still observable in 14% of this contemporary, West-European AF population. Still, MACCE occurred in only 4% of the patients after 1 year of follow-up.

AB - Background: Contemporary data regarding the characteristics, treatment and outcomes of patients with atrial fibrillation (AF) are needed. We aimed to assess these data and guideline adherence in the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) long-term general registry. Methods: We analysed 967 patients from the EORP-AF long-term general registry included in the Netherlands and Belgium from 2013 to 2016. Baseline and 1‑year follow-up data were gathered. Results: At baseline, 887 patients (92%) received anticoagulant treatment. In 88 (10%) of these patients, no indication for chronic anticoagulant treatment was present. A rhythm intervention was performed or planned in 52 of these patients, meaning that the remaining 36 (41%) were anticoagulated without indication. Forty patients were not anticoagulated, even though they had an indication for chronic anticoagulation. Additionally, 63 of the 371 patients (17%) treated with a non-vitamin K antagonist oral anticoagulant (NOAC) were incorrectly dosed. In total, 50 patients (5%) were overtreated and 89 patients (9%) were undertreated. However, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was still low with 4.2% (37 patients). Conclusions: Overtreatment and undertreatment with anticoagulants are still observable in 14% of this contemporary, West-European AF population. Still, MACCE occurred in only 4% of the patients after 1 year of follow-up.

KW - Anticoagulant

KW - Atrial fibrillation

KW - EORP

KW - Overtreatment

KW - Registry

KW - Undertreatment

UR - https://www.scopus.com/pages/publications/85114870308

U2 - 10.1007/s12471-021-01634-y

DO - 10.1007/s12471-021-01634-y

M3 - Article

C2 - 34524620

SN - 1568-5888

VL - 29

SP - 584

EP - 594

JO - Netherlands heart journal

JF - Netherlands heart journal

IS - 11

ER -

Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry

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