Evidence map›Paper›PMID 32700579›Full record

ArticleAnnals of medicine2021

Impact of multimorbidity and polypharmacy on the management of patients with atrial fibrillation: insights from the BALKAN-AF survey.

Monika Kozieł, Stefan Simovic, Nikola Pavlovic, Aleksandar Kocijancic, Vilma Paparisto, Ljilja Music, Elina Trendafilova, Anca Rodica Dan, Zumreta Kusljugic, Gheorghe-Andrei Dan and 2 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
3.0field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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  10. Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal.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 · 2023
    Review
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  16. Non-vitamin K antagonist oral anticoagulants in older and frail patients with atrial fibrillation.European heart journal supplements : journal of the European Society of Cardiology · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 11 institutions in 12 countries.

Monika KoziełLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Stefan SimovicCardiology Clinic, University Clinical Center of Kragujevac, Kragujevac, Serbia.
Nikola PavlovicClinical Center Sestre Milosrdnice, Zagreb, Croatia.
Aleksandar KocijancicCardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
Vilma PaparistoClinic of Cardiology, University Hospital Center Mother Theresa, Tirana, Albania.
Ljilja MusicCardiology Clinic, Medical Faculty, University Clinical Center of Montenegro, University of Podgorica, Podgorica, Montenegro.
Elina TrendafilovaCoronary Care Unit, National Heart Hospital, Sofia, Bulgaria.
Anca Rodica DanCardiology Department, Colentina University Hospital, Bucharest, Romania.
Zumreta KusljugicCardiology Department, Clinic of Internal Medicine, Medical Faculty, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.ORCID 0000-0002-8565-776X
Gheorghe-Andrei DanMedicine University "Carol Davila", Colentina University Hospital, Bucharest, Romania.
Gregory Y H LipLiverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Tatjana S PotparaCardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
University of Liverpool · GBCarol Davila University of Medicine and Pharmacy · ROCentar za Promociju Nauke · RSClinical Centre of Kragujevac · RSMother Teresa Hospital · ALNational Heart Hospital · BGSisters of Charity Hospital · HRSpitalul Clinic Colentina · ROUniversity Clinical Center Tuzla · BAUniversity of Belgrade · RSUniversity of Montenegro · ME

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe investigated the impact of multimorbidity and polypharmacy on the management of atrial fibrillation (AF) patients in clinical practice and assessed factors associated with polypharmacy and oral anticoagulation (OAC) use in AF patients with multimorbidity and polypharmacy.

methodsA 14-week prospective study of consecutive non-valvular AF patients was performed in seven Balkan countries.

resultsOf 2712 consecutive patients, 2263 patients (83.4%) had multimorbidity (AF + ≥2 concomitant diseases) and 1505 patients (55.5%) had polypharmacy. 1416 (52.2%) patients had both multimorbidity and polypharmacy. Overall, 1164 (82.2%) patients received OAC, 200 (14.1%) patients received antiplatelet drugs alone and 52 (3.7%) patients had no antithrombotic therapy (AT). Non-emergency centre and paroxysmal AF were significantly associated with OAC non-use in patients with multimorbidity, whilst age ≥80 years and non-emergency centre were identified to be independent predictors of OAC non-use in patients with polypharmacy.

conclusionsMultimorbidity and polypharmacy were common among AF patients in our study. AT was suboptimal and approximately 18% of multimorbid patients with polypharmacy were not anticoagulated. Pattern of AF and non-emergency centre were associated with OAC non-use in AF patients with multimorbidity, whilst non-emergency centre and age ≥80 years were associated with OAC non-use in AF patients with polypharmacy. Key Message Multimorbidity and polypharmacy are common among patients with AF. Antithrombotic therapy was suboptimal in AF patients with multimorbidity and polypharmacy. Approximately, 18% of multimorbid patients with polypharmacy were not anticoagulated.

Indexed as

MultimorbidityPolypharmacyAdministration, OralAgedAged, 80 and overAnticoagulantsAtrial FibrillationBalkan PeninsulaFemaleHumansMaleMiddle AgedProspective StudiesSurveys and QuestionnairesTreatment OutcomeAnticoagulantsAtrial fibrillationBALKAN-AF surveymultimorbiditypolypharmacy

Identifiers

PMID32700579
PMCPMC7877933
OpenAlexW3044639288

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.