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001-es BibID:	BIBFORM123486
035-os BibID:	(scopus)85201298206 (WoS)001290980100001
Első szerző:	Papp Tímea Bianka (általános orvos)
Cím:	All-Cause Mortality of Atrial Fibrillation and Heart Failure in the Same Patient : Does the Order Matter? / Papp Tímea, Rokszin György, Kiss Zoltán, Becker Dávid, Merkely Béla, Járai Zoltán, Jánosi András, Csanádi Zoltán
Dátum:	2024
ISSN:	2193-8261 2193-6544
Megjegyzések:	Introduction Atrial fibrillation (AF) and heart failure (HF) often coexist due to the common elements of the pathomechanism they share. The potential significance of the order these entities present in the same patient is ill-defined. Herein, we report our results from a nationwide database on the occurrence of various sequences AF and HF may present, the time delays between the two conditions and all-cause mortality associated with different scenarios. Methods Patients diagnosed with both AF and HF between 2015 and 2021 were enrolled from the Hungarian National Health Insurance Fund (NHIF) database. The order the two entities followed each other, and the time delay in between were registered. Median survival rates were calculated in AF???HF; HF???AF and simultaneous scenarios. Results A total of 109,075 patients were enrolled: 29,937 with AF???HF, 38,171 with HF???AF, and 40,967 diagnosed simultaneously. Time delays between AF???HF and HF???AF were 6 and 10 months, respectively. The median survival was 46 months in the AF???HF, 38 months in the HF???AF, and 21 months in the simultaneous group. Patients with HF???AF, and with simultaneous presentations had 5% and 16% greater mortality risk as compared to the AF???HF sequence, with hazard ratios (95% confidence intervals) of 0.95 (0.93?0.97) and 0.84 (0.82?0.85), respectively (P?<?0.0001). Conclusions HF occurred significantly earlier after the diagnosis of AF than vice versa. Patients diagnosed simultaneously had the worst, while the AF???HF sequence had the best prognosis. These data should have implications for the intensification of monitoring and therapy in different scenarios.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk atrial fibrillation heart failure mortality risk real-world evidence
Megjelenés:	Cardiology and Therapy. - 13 : 3 (2024), p. 615-630. -
További szerzők:	Rokszin György Kiss Zoltán (Pécs) Becker Dávid Merkely Béla (1965-) (orvos) Járai Zoltán Jánosi András Csanádi Zoltán (1960-) (kardiológus)
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001-es BibID:	BIBFORM111209
035-os BibID:	(scopus)85151758723
Első szerző:	Papp Tímea Bianka (általános orvos)
Cím:	Mortality on DOACs Versus on Vitamin K Antagonists in Atrial Fibrillation : Analysis of the Hungarian Health Insurance Fund Database / Papp Tímea Bianka, Kiss Zoltán, Rokszin György, Fábián Ibolya, Márk László, Bagoly Zsuzsa, Becker Dávid, Merkely Béla, Aradi Dániel, Dézsi Csaba András, Járai Zoltán, Csanádi Zoltán
Dátum:	2023
ISSN:	0149-2918
Megjegyzések:	Purpose: Limited real-world data are available on the survival of patients treated with vitamin K antagonists (VKAs) versus with direct oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF). In this nationwide registry, we analyzed the mortality risk of patients with nonvalvular AF taking DOACs versus. VKAs, with a special attention to the early treatment period. Methods: The Hungarian National Health Insurance Fund (NHIF) database was searched to identify patients treated with VKA or DOAC as a thromboembolic prophylaxis for nonvalvular AF between 2011 and 2016. The overall and the early (0-3, 4-6, 7-12 months) mortality risks with the 2 types of anticoagulation were compared. A total of 144,394 patients with AF treated with either a VKA (n = 129,925) or a DOAC (n = 14,469) were enrolled. Findings: A 28% improvement in 3-year survival with DOAC treatment compared with VKA treatment was shown. Mortality reduction with DOACs was consistent across different subgroups. However, younger patients (30-59 years old) initiated on DOAC therapy had the greatest RRR (53%) in mortality. Furthermore, DOAC treatment also yielded a benefit of greater magnitude (HR 0.55; 95% CI, 0.40-0.77; p=0.001) in the lower (0-1) CHA2DS2-VASc score segment and in those with fewer (0-1) bleeding risk factors (HR: 0.50; 95% CI, 0.34-0.73; p=0.001). The RRR in mortality with DOACs was 33% within the first 3 months, and 6% in the second year. Implications: Thromboembolic prophylaxis with DOACs in this study yielded significantly lower mortality compared with VKA treatment in patients with nonvalvular AF. The largest benefit was shown in the early period after treatment initiation, as well as in younger patients, those with a lower CHA2DS2-VASc score, and those with fewer bleeding risk factors.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk atrial fibrillation direct oral anticoagulant mortality risk reduction thromboembolism vitamin K antagonist
Megjelenés:	Clinical Therapeutics. - 45 : 4 (2023), p. 333-346. -
További szerzők:	Kiss Zoltán (Pécs) Rokszin György Fábián Ibolya Márk László (1956-) (belgyógyász, kardiológus) Bagoly Zsuzsa (1978-) (orvos) Becker Dávid Merkely Béla (1965-) (orvos) Aradi Dániel Dézsi Csaba András Járai Zoltán Csanádi Zoltán (1960-) (kardiológus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00043 GINOP
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