Turkish Real-Life Atrial Fibrillation in Clinical Practice: 2-Year Clinical Outcomes of the TRAFFIC Study
Anatolian Journal of Cardiology, cilt.30, sa.2, ss.116-123, 2025 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.14744/anatoljcardiol.2025.5751
- Dergi Adı: Anatolian Journal of Cardiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.116-123
- Anahtar Kelimeler: Atrial fibrillation, NOAC, registries, TRAFFIC registry, Türkiye
- Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Atrial fibrillation (AF) is a major public health issue associated with thromboembolism and mortality. Real-world data from Türkiye are limited despite expanding use of non-vitamin K antagonist oral anticoagulants (NOACs). The Turkish Real Life Atrial Fibrillation in Clinical Practice (TRAFFIC) study aimed to characterize the demographic features, risk profiles, treatment patterns, and 2-year clinical outcomes of patients with non-valvular AF (NVAF) in Türkiye. Methods: TRAFFIC was a national, prospective, multicenter, observational registry enrolling 1659 NVAF patients from 36 centers with 6-monthly follow-up for 24 months. Baseline data included demographics, comorbidities, CHA₂DS₂-VASc, HAS-BLED, AF subtype, European Heart Rhythm Association (EHRA) score, and antithrombotic therapy. Outcomes were ischemic stroke/systemic embolism (SE), major bleeding, and all-cause mortality. Predictors of mortality were evaluated using adjusted Cox regression, and associations of risk scores were explored using univariate Cox models with restricted cubic splines. Results: Median age was 70 years, 48% female, with intermediate CHA₂DS₂-VASc (most 2-5) and low-to-intermediate HAS-BLED scores (most 0-2). Permanent AF was the most common subtype (48%). Antithrombotic therapy largely reflected risk profiles, with NOACs being the dominant treatment (65%). Over 2 years, all-cause mortality was 8.9%, ischemic stroke/SE 2.4%, and major bleeding 1.3%. In adjusted analysis, age, congestive heart failure, and diabetes mellitus were independent predictors of mortality. Both CHA₂DS₂-VASc and HAS-BLED scores showed threshold effects for mortality and thromboembolic risk but not for bleeding. Conclusion: TRAFFIC provides contemporary Turkish NVAF data, showing lower event rates than historical cohorts. Outcomes are comparable with international registries; persistent mortality burden highlights the need for AF care beyond anticoagulation.