LAUSR

INTRODUCTION Data on antithrombotic treatment among patients with atrial fibrillation (AF) in Poland are limited. OBJECTIVES To describe antithrombotic management within Polish part of the EURObservational Research Programme - AF General Long-Term Registry. PATIENTS AND METHODS Data collected at baseline, and at 1-year follow-up visit from 701 Polish patients included in 25 Polish centers in years 2013-2016 were analyzed. RESULTS Any antithrombotic therapy was administered to 94% of patients (vitamin K antagonists [VKA]:53%, non-VKA oral anticoagulants [NOAC]:36%, antiplatelet therapy [APT]:4.8%). However, 78% of Polish patients considered as 'low-risk patients' (CHA2DS2-VASc 0 in males or 1 in females) were prescribed OAC and 12% had APT. Independent predictors of both NOAC and VKA use were first detected AF and device therapy. Predictors of VKA use were lone AF, history of ischemic stroke, pulmonary embolism/deep vein thrombosis; NOAC use: AF permanent; APT use: history of hemorrhagic events, first detected and persistent AF; resignation from antithrombotic treatment: young age. Incorrect prescribing of NOAC occurred more often in the reduced-dose NOAC group compared with the full-dose group (30% vs 7%). During follow-up period, all-cause mortality rate was 5.2%, 0.8%, 15% and 7.0% (p <0.0001) and thromboembolic event risk was 0.4%, 0.5%, 6.2% and 0% (p = 0.04) of patients on VKA, NOAC, APT and without antithrombotic treatment, respectively. CONCLUSIONS Patients with the lowest stroke risk are often overtreated. The choice of proper antithrombotic strategy does not depend solely on factors incorporated into CHA2DS2-VASc score. Higher mortality rate is observed among APT-treated patients or those without antithrombotic treatment.