Observational studyClinical research in cardiology : official journal of the German Cardiac Society2016
Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study.
Observational study in Clinical research in cardiology : official journal of the German Cardiac Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2021Pooled it
- Education of healthcare professionals to improve guideline adherence in atrial fibrillation: the STEEER-AF cluster-randomized clinical trial.Nature medicine · 2025Trial
- Appropriateness of prescription of oral anticoagulant therapy in acutely hospitalized older people with atrial fibrillation. Secondary analysis of the SIM-AF cluster randomized clinical trial.British journal of clinical pharmacology · 2019Trial
- Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation.British journal of clinical pharmacology · 2018Trial
- Prevalence, Incidence, and Impact of Cancer in Atrial Fibrillation: A Systematic Review and Meta-Analysis of 70,000,000 Patients.Health science reports · 2026Review
- Anticoagulant Therapy in Elderly Hospitalized Patients with Atrial Fibrillation: A Critical Appraisal of Data from the Italian REPOSI Registry.Journal of clinical medicine · 2026Article
- Antiarrhythmic drug use in atrial fibrillation among different European countries - as determined by a physician survey.International journal of cardiology. Heart & vasculature · 2025Article
- Edoxaban treatment in routine clinical practice is highly concordant with the 2020 European Society of Cardiology atrial fibrillation guidelines: results from the noninterventional Global ETNA-AF programme.European heart journal open · 2025Article
- Article
- Drug prescription appropriateness in hospitalized older patients: 15-year results and lessons from a countrywide register.Internal and emergency medicine · 2024Review
- Design and deployment of the STEEER-AF trial to evaluate and improve guideline adherence: a cluster-randomized trial by the European Society of Cardiology and European Heart Rhythm Association.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Streamlining atrial fibrillation ablation management using a digitization solution.European heart journal. Digital health · 2024Article
- Infographic summaries for clinical practice guidelines: results from user testing of the BMJ Rapid Recommendations in primary care.BMJ open · 2023Article
- The overall quality of evidence of recommendations surrounding nutrition and diet in inflammatory bowel disease.International journal of colorectal disease · 2023Review
- Guidelines, Position Statements, and Standardizations: Documents to Assist Medical Practice.Arquivos brasileiros de cardiologia · 2022Article
- Article
- Guidelines, guidelines and more guidelines for haemorrhoid treatment: A review to sort the wheat from the chaff.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Review
- AIM-AF: A Physician Survey in the United States and Europe.Journal of the American Heart Association · 2022Article
- The Rate of Clinical Outcomes in Atrial Fibrillation according to Antithrombotic Strategy: The COOL-AF Registry.Cardiovascular therapeutics · 2022Article
- Evolution of antithrombotic therapy for patients with atrial fibrillation: The prospective global GLORIA-AF registry program.PloS one · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) is associated with a substantial risk of thromboembolism and mortality, significantly reduced by oral anticoagulation. Adherence to guidelines may lower the risks for both all cause and cardiovascular (CV) deaths.
methodsOur objective was to evaluate if antithrombotic prophylaxis according to the 2012 European Society of Cardiology (ESC) guidelines is associated to a lower rate of adverse outcomes. Data were obtained from REPOSI; a prospective observational study enrolling inpatients aged ≥65 years. Patients enrolled in 2012 and 2014 discharged with an AF diagnosis were analysed.
resultsAmong 2535 patients, 558 (22.0 %) were discharged with a diagnosis of AF. Based on ESC guidelines, 40.9 % of patients were on guideline-adherent thromboprophylaxis, 6.8 % were overtreated, and 52.3 % were undertreated. Logistic analysis showed that increasing age (p = 0.01), heart failure (p = 0.04), coronary artery disease (p = 0.013), peripheral arterial disease (p = 0.03) and concomitant cancer (p = 0.003) were associated with non-adherence to guidelines. Specifically, undertreatment was significantly associated with increasing age (p = 0.001) and cancer (p < 0.001), and inversely associated with HF (p = 0.023). AF patients who were guideline adherent had a lower rate of both all-cause death (p = 0.007) and CV death (p = 0.024) compared to those non-adherent. Kaplan-Meier analysis showed that guideline-adherent patients had a lower cumulative risk for both all-cause (p = 0.002) and CV deaths (p = 0.011). On Cox regression analysis, guideline adherence was independently associated with a lower risk of all-cause and CV deaths (p = 0.019 and p = 0.006).
conclusionsNon-adherence to guidelines is highly prevalent among elderly AF patients, despite guideline-adherent treatment being independently associated with lower risk of all-cause and CV deaths. Efforts to improve guideline adherence would lead to better outcomes for elderly AF patients.
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