scholarly journals MO374DISCLOSURE OF THE RESULTS OF A 40-YEARS RESEARCH OF UPPER TRACT UROTHELILAL CANCER AND BALKAN ENDEMIC NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Stevan Glogovac ◽  
Zorica Dimitrijevic ◽  
Miomir Stojanovic ◽  
Danijela Tasic ◽  
Karolina Paunovic ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Linear Trend ◽  
Annual Incidence ◽  
Balkan Endemic Nephropathy ◽  
Annual Incidence Rate ◽  
Upper Tract ◽  
Clinical Center ◽  
Average Annual Incidence ◽  
Endemic Nephropathy ◽  
Observation Period

Abstract Background and Aims The general significance of Balkan endemic nephropathy (BEN) is the association with upper tract urtohelial cancer (UTUC). In published papers studying these two entities, there is large difference between the obtained results. By UTUC research, obtained results are the most diverse in relation to the period and region of research. The aim of the research is to show the discrepancy between the results of the research of UTUC of Jablanica district in relation to the observation period and the type of settlement. Method The research period lasted from 1978-2017. During the analysis of the frequency of UTUC, we used the operative material of Urology Department, Health Care Center, Leskovac , and Urology Clinic, Clinical Center, Nis, Clinical Center, Nis. For practical reasons, this period was devided into two periods, the first (1978-1997) and the second (1998-2017). In order to make classification of settlements we used the data of the Institute of Nephrology and Hemodialysis in Nis (A-endemic regions, B-hypo-endemic, C-non-endemic urban, D-non-endemic rural regions). Data on the total number of Jablanica region population were obtained on the basis of the censuses from 1991 and 2011. The average annual incidence rate (AAIR) was calculated per 100 000 people. Finally, we jointly observed groups A and B (endemic areas) C and D (non-endemic areas) for UTUC. Results The average annual incidence rate (AAIR) in the period of 1978-2017 in endemic settlements of Jablanica region was (11.82), while in hypo-endemic was (4.49) and non-endemic (0.83). The data demonstrated that inhabitants of endemic settlements has 14.24 times higher UTUC frequency in comparison to non-endemic settlements in time span of research. Our research in Jablanica region also demonstrated unexpectedly high frequency of on UTUC not only in endemic settlements with BEN (Kutles village- 1 tumor per 99.63 and AAIR 40.15), but also in some of the non-endemic area (Brejanovac village-1 tumour per 98.75 people and AAIR of 40.50; Rudare village-1 tumour per 139.50 people and AAIR of 28.67; Bogojevce village-1 tumour per 187.63 people and AAIR 21.32). This occurrence of UTUC frequency in some non-endemic settlements refers to the first observed period until no occurrence was recorded in the second observed period. There is a higher UTUC frequency in endemic settlements of 11.37 in the first period (A- AAIR 21.95), while in hypo-endemic (B-AAIR 11.82) is 3.64 higher incedence. In non-endemic settlements (C,D-AAIR 1.09) there is 1.63 higher incidence in comparison to the second period. Observing the periods, there is a higher UTUC frequency of five times in endemic settlements (A, B) of Jablanica region in the first period comparing to the second. The linear trend of UTUC in the 40-year period demonstrates a slow decrease (y= -0.0797x + 4.2846; r2 = 0.2028) in Jablanica region. In the same observed period, linear trend of BEN is in corelation of decreased linear trend of UTUC (y= -0.164x+6.0669; r2 =0.748). Conclusion A forty-year study of UTUC in the Jablanica region showed a discrepancy between the results in relation to the observation period and the type of settlement, which coincides with the generally accepted view that epidemiology is the most fascinating part of BEN. In endemic settlements, in the second observed period, the frequency of UTUC was registered five times lower than in the first, which coincides with the decrease in the frequency of BEN in these settlements.

scholarly journals Subarachnoid hemorrhage after surgical treatment of unruptured intracranial aneurysms

2018 ◽  
Vol 129 (2) ◽  
pp. 490-497
Author(s):  
Hidetoshi Matsukawa ◽  
Hiroyasu Kamiyama ◽  
Toshiyuki Tsuboi ◽  
Kosumo Noda ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Incidence Rate ◽  
Intracranial Aneurysms ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
Excellent Outcome ◽  
Unruptured Intracranial Aneurysms ◽  
Average Annual Incidence

OBJECTIVEOnly a few previous studies have investigated subarachnoid hemorrhage (SAH) after surgical treatment in patients with unruptured intracranial aneurysms (UIAs). Given the improvement in long-term outcomes of embolization, more extensive data are needed concerning the true rupture rates after microsurgery in order to provide reliable information for treatment decisions. The purpose of this study was to investigate the incidence of and risk factors for postoperative SAH in patients with surgically treated UIAs.METHODSData from 702 consecutive patients harboring 852 surgically treated UIAs were evaluated. Surgical treatments included neck clipping (complete or incomplete), coating/wrapping, trapping, proximal occlusion, and bypass surgery. Clippable UIAs were defined as UIAs treated by complete neck clipping. The annual incidence of postoperative SAH and risk factors for SAH were studied using Kaplan-Meier survival analysis and Cox proportional hazards regression models.RESULTSThe patients’ median age was 64 years (interquartile range [IQR] 56–71 years). Of 852 UIAs, 767 were clippable and 85 were not. The mean duration of follow-up was 731 days (SD 380 days). During 1708 aneurysm years, there were 4 episodes of SAH, giving an overall average annual incidence rate of 0.23% (95% CI 0.12%–0.59%) and an average annual incidence rate of 0.065% (95% CI 0.0017%–0.37%) for clippable UIAs (1 episode of SAH, 1552 aneurysm-years). Basilar artery location (adjusted hazard ratio [HR] 23, 95% CI 2.0–255, p = 0.0012) and unclippable UIA status (adjusted HR 15, 95% CI 1.1–215, p = 0.046) were significantly related to postoperative SAH. An excellent outcome (modified Rankin Scale score of 0 or 1) was achieved in 816 (95.7%) of 852 cases overall and in 748 (98%) of 767 clippable UIAs at 12 months.CONCLUSIONSIn this large case series, microsurgical treatment of UIAs was found to be safe and effective. Aneurysm location and unclippable morphologies were related to postoperative SAH in patients with surgically treated UIAs.

scholarly journals Descriptive epidemiology of measles cases in Bauchi State, 2013–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Polycarp Uchechukwu Ori ◽  
Ayo Adebowale ◽  
Chukwuma David Umeokonkwo ◽  
Ugochukwu Osigwe ◽  
Muhammad Shakir Balogun
Keyword(s):  
Incidence Rate ◽  
Case Fatality ◽  
Secondary Data ◽  
Outcome Data ◽  
Annual Incidence ◽  
High Morbidity ◽  
Annual Incidence Rate ◽  
Average Annual Incidence ◽  
History Of ◽  
Variation Index

Abstract Background Measles accounts for high morbidity and mortality in children, especially in developing countries. In 2017, about 11,190 measles cases were recorded in Nigeria, including Bauchi State. The aim of this study was to describe the trend and burden of measles in Bauchi State, Nigeria. Method We analyzed secondary data of measles cases extracted from the Measles Surveillance data system in Bauchi State from January 2013 to June 2018. The variables extracted included age, sex, doses of vaccination, case location and outcome. Data were analyzed using descriptive statistics, logistic regression, and multiplicative time series model (α = 0.05). Results A total of 4935 suspected measles cases with an average annual incidence rate of 15.3 per 100,000 population and 57 deaths (Case Fatality Rate, CFR: 1.15%) were reported. Among the reported cases, 294 (6%;) were laboratory-confirmed, while clinically compatible and epi-linked cases were 402 (8%) and 3879 (70%), respectively. Of the 4935 measles cases, 2576 (52%) were males, 440 (9%) were under 1 year of age, and 3289 (67%) were between 1 and 4 years. The average annual incidence rate among the 1–4 year age-group was 70.3 per 100,000 population. The incidence rate was lowest in 2018 with 2.1 per 100,000 and highest in 2015 with 26.2 per 100,000 population. The measles cases variation index per quarter was highest in quarter 1 (198.86), followed by quarter 2 (62.21) and least in quarter 4 (10.37) of every year. Only 889 (18%) of the measles cases received at least one dose of measles vaccine, 2701 (54.7%) had no history of measles vaccination while 1346 (27.3%) had unknown vaccination status. The fatality of measles in Bauchi State were significantly associated with being under 5 years (AOR = 5.58; 95%CI: 2.19–14.22) and not having at least a dose of MCV (OR = 7.14; 95%CI: 3.70–14.29). Conclusion Measles burden remains high in Bauchi State despite a decrease in its incidence over the study years. Most of the cases occurred in the first quarter of every year. Improved routine measles surveillance for prompt case management could reduce the burden of the disease in Bauchi State.

Acute myocardial infarction incidence and mortality rates in the population of the city of Nis in the period 1974-2000

2007 ◽  
Vol 60 (9-10) ◽  
pp. 479-483
Author(s):  
Marko Lazovic ◽  
Milica Lazovic ◽  
Gordana Devecerski ◽  
Vladmila Bojanic ◽  
Nebojsa Krstic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Incidence Rate ◽  
Mortality Rates ◽  
Progressive Increase ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
Female Ratio ◽  
Average Annual Incidence ◽  
The City

Introduction. The aim of this study was to investigate the annual incidence of hospital morbidity and mortality rates of acute myocardial infarction (AMI) in the population of Nis who were treated at the Cardiology Clinic in Nis during the period 1974-2000. Material and Methods. A retrospective clinical-epidemiological study was carried out in the population of the city of Nis aged 30 years and over. The number of citizens of Nis, aged 30 years and over, was 71.500 in 1974, and 100.000 in 2000, while the male to female ratio was 48 %:52%. Results. During the period from 1974 to 2000, 4319 patients of both sexes with AMI received hospital treatment. The average annual incidence rate was 159.92 per 100.000 inhabitants aged 30 years and over. The average annual incidence of AMI showed a trend of progressive increase, and in 2000 it was 274.87 (2.7 times higher than in 1974 - 102.19). The average annual mortality for both sexes was 11.57% (9.82% for males and 15.89% for females). The female mortality rate was significantly higher (p< 0.001). Conclusion. Trends in annual incidence rate of AMI in the population of the city of Nis aged 30 years and over are characterized by progressive increase during the period from 1974 to 2000. The trend line: yt = 159.92+6.2432x shows that without primary prevention further increase in the incidence of AMI can be expected. .

SAT0524 THE INCIDENCE RATE OF ADULT ONSET STILL’S DISEASE IN SLOVENIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1218-1219
Author(s):  
A. Hocevar ◽  
Z. Rotar ◽  
M. Krosel ◽  
M. Plešivčnik Novljan ◽  
S. Praprotnik ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Clinical Characteristics ◽  
Annual Incidence ◽  
Adult Onset Still’S Disease ◽  
Adult Onset ◽  
Still’S Disease ◽  
Annual Incidence Rate ◽  
Still's Disease ◽  
Average Annual Incidence ◽  
Adult Onset Still's Disease

Background:Adult Onset Still’s disease (AOSD) is an uncommon systemic inflammatory disease.Objectives:To determine for the first time the incidence rate of AOSD in our population.Methods:We retrospectively collected AOSD cases diagnosed between 1 January 2010 and 31 December 2019 at our secondary/tertiary rheumatology centre, which is the only referral centre for an average population of 704,000 adults. AOSD cases were identified by searching the electronic medical database both for ICD-10 code M06.1 and a full text search for »AOSD«. Patients’ records were analyzed and descriptive statistics was used to describe our study group. The adult population was obtained from the national statistics institute database. The annual incidence rate for AOSD was calculated.Results:During the 10-year observation period we identified 22 incipient AOSD cases. All 22 cases fulfilled Yamaguchi classification criteria for AOSD1. Five cases were excluded from analyses since they were referred to our department from regions served by other secondary/tertiary centres. Hence, we finally analyzed 17 AOSD cases (11 females; median (IQR) age 38.9 (29.9; 56.5) years, range 20-71 years), resulting in the average annual incidence rate of 2.4 (95%CI 1.5-3.8) cases per 106adults. Age specific incidence rate of AOSD is presented in Figure 1. Clinical characteristics of AOSD cases at presentation are shown in Table 1. AOSD was complicated with macrophage activating syndrome in 4/17 (23.5%) cases, and with pulmonary hypertension in one case. Patients were followed for a median (IQR) 31 (20; 58) months. Twelve (70.5%), 2 (11.8%), and 3 (17.6) patients had monophasic, relapsing, and chronic disease course, respectively.Table 1.Clinical characteristics of AOSD at presentationCharacteristicAOSD (%)CharacteristicAOSD (%)Female gender64.7Lung infiltrates23.5Age*38.9 (29.9;56.5)Pericardial effusion23.5Fever94.1Abdominal pain17.6Weight loss64.7Lymphadenopathy52.9Skin rash76.5Splenomegaly41.2Throat pain88.2Hepatomegaly17.6Arthralgia/Arthritis88.2/47.1Leukocytosis88.2Myalgia29.4Elevated AST/ALT88.2Pleural effusion23.5Ferritin >1000ng/ml94.1Legend: *median (IQR);Figure 1.Age specific incidence rate of AOSDConclusion:AOSD is rare in our population, with an average annual incidence rate of 2.4 cases per 106adults.References:[1]Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, et al. Preliminary criteria for classification of adult Still’s disease. J Rheumatol. 1992;19(3):424-30.Acknowledgments -Disclosure of Interests:ALOJZIJA HOCEVAR: None declared, Ziga Rotar Consultant of: Speaker and consulting fees from Abbvie, Amgen, Biogen, Eli Lilly, Medis, MSD, Novartis, Pfizer, Roche, Sanofi., Speakers bureau: Speaker and consulting fees from Abbvie, Amgen, Biogen, Eli Lilly, Medis, MSD, Novartis, Pfizer, Roche, Sanofi., Monika Krosel: None declared, Martina Plešivčnik Novljan: None declared, Sonja Praprotnik: None declared, Matija Tomsic: None declared

scholarly journals P0827BALKAN ENDEMIC NEPHROPATHY AND UPPER TRACT UROTHELIAL CANCER INCIDENCE - 40 YEAR FOLLOW

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Stevan Glogovac ◽  
Zorica Dimitrijevic ◽  
Miomir Stojanovic ◽  
Danijela Tasic ◽  
Karolina Paunovic ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Frequency ◽  
Linear Trend ◽  
Care Center ◽  
Balkan Endemic Nephropathy ◽  
Etiologic Factor ◽  
Health Care Center ◽  
Upper Tract ◽  
Endemic Nephropathy ◽  
Epidemiological Characteristics

Abstract Background and Aims Balkan endemic nephropathy (BEN) is a chronic tubulointestitial kidney disease prevalent in Serbia, Bosnia, Croatia, Bulgaria and Romania. One of its most peculiar characteristics is a strong association with upper tract urothelial carcinoma (UTUC). The aim of the paper is to assess the basic epidemiological characteristics of UTUC, such as the incidence, sex, age geographic distribution of the diseased from Jablanica region in the 40-year period, as well as determining the linear trend of UTUC frequency in regions with BEN compared to non-endemic regions, bearing in mind those recent studies that have shown a significant decrease in the incidence of the diseased from BEN. Method The research period lasted from 1978 to 2017. In the analysis of the frequency of UTUC, we used the operative material of Urology Department, Health Care Center, Leskovac, and Urology Clinic, Clinical Center, Nis. The patients were divided according to the place of residence-certain areas of Jablanica region. The data from the Institutes of Nephrology and Hemodialysis were used for the classification of the area(A-endemic settlements for BEN; B-hypo-endemic; C-non-endemic urban type; and D-non-endemic rural type. The average annual incidence rate (AAIR) was calculated per 100 000 people. Finally, e jointly observed groups C and D(non-endemic areas) for UTUC. For practical reasons, this period was divided into the first(1978-1997) and the second one(1998-2017). Results The highest AAIR of UTUC was registered in endemic settlements(11.82) and the lowest one in non-endemic urban settlements(0.83). Association of UTUC and other tumours were observed in 39.13% in endemic regions compared to 22.53% in non-endemic regions. In endemic settlements in the first observed period, the frequency of UTUC was registered five times higher than in the second. The linear trend of UTUC in the 40-year-period shows a slow decrease(y=-0.0797x+4.2846; r2=0.2028). In addition, there was strong positive linear trend toward urinary bladder cancer occurence(y=1.6415 + 3.45; r2=0.85). However, trend of occurence of bladder cancer in endemic regions were positive, but without significance(y=0.023x+57; r2=0.0004). The results show that UTUC in endemic settlements are 2.63 times more frequent than in hypo-endemic ones; 14.24 times more frequent than in non-endemic settlements. Our research in Jablanica region also demonstrated unexpectedly high frequency of on UTUC not only in certain endemic settlements with BEN but also in the non-endemic area-Brejanovac village-1 tumour per 99.63 people and AAIR of 40.50, Rudare village-1 tumour per 139.50 people and AAIR 28.67. This occurrence of UTUC frequency in some non-endemic settlements refers to the first observed period until no occurrence was recorded in the second observed period. Conclusion The high frequency of UTUC in the regions with BEN in Jablanica region possibly point to the common nephropathogenic and carcinogenic etiologic factor and confirms the existence of a positive correlation between BEN and UTUC. It is necessary that additional investigations be carried out in certain non-endemic settlements in which the frequency of UTUC and hemodialyzed patients in still high.

scholarly journals FEATURES OF SEASONAL MANIFESTATION OF BRUCELLOSIS INFECTION AMONG THE POPULATION OF THE REPUBLIC OF TAJIKISTAN

2019 ◽  
Vol 1 (1) ◽  
pp. 63-67
Author(s):  
K. M. Kurbonov ◽  
E. G. Simonova ◽  
N. N. Filatov
Keyword(s):  
Incidence Rate ◽  
Preventive Measures ◽  
Climatic Conditions ◽  
Annual Incidence ◽  
Farm Animals ◽  
Annual Incidence Rate ◽  
Epidemiological Analysis ◽  
Economic Transformations ◽  
The Republic ◽  
The Impact

The aim of this work was to study modern manifestations of seasonal brucellosis among the population of the Republic of Tajikistan. The materials and methods: of the study were the official statistics, as well as the results of previously performed studies on the risk assessment of the incidence in population. A retrospective epidemiological analysis of annual incidence rate for the period from 1997 to 2016 was conducted, depending on the most significant social and environmental risk factors. Results. The article shows the impact on the annual incidence rate of socio-economic transformations, including the privatization of collective livestock farms, accompanied by the massive movement of farm animals to private ownership, the loss of practice in animal breeding, and changes in environmental and climatic conditions. Against the background of the intensification of sheep breeding, there is a tendency in seasonality smoothing and shifting the maximum levels of population incidence of brucellosis to the spring season. Conclusion. The modern features of seasonal manifestation of brucellosis infection in the Republic of Tajikistan make it necessary to apply a differentiated approach to planning and conducting preventive measures in various areas of the country.

scholarly journals Community outbreak of hepatitis A in southern Italy – Campania, January-May 2004

2004 ◽  
Vol 8 (23) ◽  
Author(s):  
D Boccia
Keyword(s):  
Incidence Rate ◽  
Hepatitis A ◽  
Southern Italy ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
Total Rate ◽  
Endemic Disease

Campania, a region in southern Italy, is one of the 20 political regions in Italy. Hepatitis A (HAV) is an endemic disease here, with an annual incidence rate often twice as high as the total rate for the rest of Italy

scholarly journals The inverse relationship between national food security and annual cholera incidence: a 30-country analysis

2019 ◽  
Vol 4 (5) ◽  
pp. e001755 ◽  
Author(s):  
Aaron Richterman ◽  
Andrew S Azman ◽  
Georgery Constant ◽  
Louise C Ivers
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Incidence Rate ◽  
Inverse Relationship ◽  
Negative Binomial ◽  
National Level ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
The Relationship ◽  
National Food Security

IntroductionIndividual and household-level evidence suggests a relationship between food insecurity and cholera risk. The relationship between national food security and the size of cholera outbreaks is unknown.MethodsWe analysed the relationship between national food security and annual cholera incidence rate from 2012 to 2015 across 30 countries. We used components of the Global Food Security Index (GFSI) as measures of food security. We included countries with available GFSI reporting cases of cholera during the study period, excluding high-income countries. We developed multivariable zero-inflated negative binomial models with annual cholera incidence rate as the outcome, GFSI components as the exposure of interest, fixed effects for country and year, and time-varying effects related to water, sanitation, and hygiene, oral cholera vaccine deployment, healthcare expenditure, conflict and extreme weather.ResultsThe 30 countries reported 550 106 total cases of cholera from 2012 to 2015, with a median annual incidence rate of 3.1 cases per 100 000 people (IQR 0.3–9.9). We found independent inverse relationships between cholera and Overall GFSI (incidence rate ratio (IRR) 0.57, 95% CI 0.43 to 0.78), GFSI-Availability (IRR 0.81, 95% CI 0.70 to 0.95) and GFSI-Affordability (IRR 0.76, 95% CI 0.62 to 0.92).ConclusionsWe identified a strong inverse relationship between national food security and annual incidence rate of cholera. In the context of prior evidence at the individual and household levels, this suggests that there is a linkage between food insecurity and cholera at the national level that should be further considered in assessing cholera risk in vulnerable regions and in designing cholera control interventions.

scholarly journals Ten-year trends in the incidence, treatment and outcomes of patients with mitral stenosis in Korea

Heart ◽  
2020 ◽  
Vol 106 (10) ◽  
pp. 746-750 ◽  
Author(s):  
Ju Youn Kim ◽  
Sung-Hwan Kim ◽  
Jun Pyo Myong ◽  
Young Choi ◽  
You Mi Hwang ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Mitral Stenosis ◽  
Anticoagulation Therapy ◽  
Large Data ◽  
Vitamin K Antagonist ◽  
Annual Incidence ◽  
Annual Incidence Rate ◽  
Systemic Embolism ◽  
Stroke Incidence ◽  
Changing Patterns

ObjectiveMitral stenosis increases the risk of atrial fibrillation (AF) and stroke. Large data underlying the trend in incidence, treatment and outcomes of mitral stenosis are lacking.MethodsBased on the Health Insurance Review and Assessment Service database in Republic of Korea, patients who were diagnosed with mitral stenosis between 2007 and 2016 were enrolled. Trends in the incidence rate and changing patterns of treatment and outcome for stroke and systemic embolism and intracranial haemorrhage (ICH) were analysed.ResultsA total of 42 075 patients (mean age 60.7±13.5 years, 13 303 (31.6%) male) were included in the present study. The number included 27 824 (66.1%) patients with mitral stenosis and comorbid AF. The age-standardised annual incidence rate per 100 000 of mitral stenosis in Korea decreased remarkably from 10.3 to 3.6 over 10 years. The use of anticoagulation therapy increased consistently. The annual incidence of stroke and systemic embolism showed signs of plateau, while the incidence of ICH increased.ConclusionsThe overall incidence rate of mitral stenosis in Korean population has decreased remarkably. As increasing the use of vitamin K antagonist, the annual incidence rate of ICH was increased but the rate of stroke incidence reached a plateau. Alternative effective anticoagulation strategy should be investigated.

Atrial Fibrillation and Mitral Regurgitation: Clinical Performance of Direct Oral Anticoagulants in a Real-World Setting

2020 ◽  
Vol 25 (6) ◽  
pp. 564-569
Author(s):  
Enrico Melillo ◽  
Anna Rago ◽  
Riccardo Proietti ◽  
Emilio Attena ◽  
Maddalena Carrella ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Regurgitation ◽  
Incidence Rate ◽  
Real World ◽  
Clinical Performance ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Annual Incidence ◽  
Research Database ◽  
Annual Incidence Rate

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is frequently present in patients with mitral regurgitation (MR). Currently, there is a lack of real-world evidence specifically addressing the clinical performance of direct oral anticoagulants (DOACs) in patients with AF and concomitant MR. Therefore, the aim of the present study was to assess the efficacy and safety profile of DOACs therapy in patients with AF and MR. Methods: Data for this study were sourced from the Atrial Fibrillation Research Database in the Department of Cardiology at Monaldi Hospital. The database was queried for AF patients with MR who were prescribed DOACs therapy. The primary safety outcome was defined as the annual incidence rate of major bleeding events and the primary effectiveness outcome as the annual incidence rate of all events classified as ischemic stroke, transient ischemic attacks, and systemic embolisms. Results: Consecutive AF patients with concomitant mild to severe MR who received DOACs therapy (n = 259) were included. Patients were dichotomized in 2 groups according to MR severity: a mild-to-moderate group (MR 1-2+; n = 151) and a moderate-to-severe group (MR 3-4+; n = 108). The incidence rate of major bleedings was significantly higher in MR 3-4+ group (3.92%) compared with the MR 1-2+ group (1.18%; hazard ratio [HR]: 3.2; 95% CI: 1.4-7.3; P = .0059). The incidence rate of thromboembolic events between MR 3-4+ group (0.66%) and MR 1-2+ group (0.62%) was not significantly different (HR: 0.75; P = .823). Conclusions: In the present study, there was no difference in the efficacy profile of DOACs between AF patients with mild-to-moderate and moderate-to-severe MR. Considering the increased bleeding risk, a close and careful follow-up should be warranted for patients with moderate-to-severe MR.

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