Community-based analysis of stroke prevention and effect of public interventions in atrial fibrillation: results from the ARENA project.

IF 3.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Research in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-08-08 DOI:10.1007/s00392-024-02510-6

Maura M Zylla, Belgin Özdemir, Matthias Hochadel, U Zeymer, Ibrahim Akin, Armin Grau, Steffen Schneider, Angelika Alonso, Bernd Waldecker, Tim Süselbeck, Harald Schwacke, Markus Haass, Ralf Zahn, Martin Borggrefe, Jochen Senges, Norbert Frey, Dierk Thomas

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引用次数: 0

Abstract

Background: Community-based interventions may promote awareness and adherence to atrial fibrillation (AF)-related therapies, potentially reducing adverse events. The ARENA project investigated the health status, therapies and events in AF patients in the Rhein-Neckar Region, Germany. The subproject "ARENA intervention" studied the effect of community-based interventions on AF-associated outcomes.

Methods: From 2016 onward, patients with diagnosed AF were recruited for the observational ARENA registry. In 2018, an intervention period was initiated involving population-based information campaigns on AF diagnosis and therapies. The "control group" was recruited prior to initiation, and the "intervention group" afterward. Patients underwent standardized follow-up > 1 year after recruitment. Clinical outcomes, therapy and quality of life were compared between the two groups.

Results: A total of 2769 patients were included. This real-world cohort showed high adherence to oral anticoagulation therapy (OAC) and an increased use of NOACs over vitamin K antagonists over time. In the intervention group (n = 1362), more patients continued OAC at follow-up (87.1% vs. 81.5%, P = 0.002). However, this difference was not significant in the patient subgroup with class I/IIa indications for OAC (90.1% vs. 87.5%, P = 0.11). AF-related re-hospitalization was lower in the intervention group (6.8% vs. 12.3%, P < 0.001). There was no significant difference in quality of life. AF-related anxiety was reduced at follow-up. Of note, nearly a quarter of all patients stated that ARENA had influenced their health perception.

Conclusion: Tailored community-based campaigns may raise awareness for AF-related health issues, supporting therapy adherence. Future public strategies to improve quality of life in AF patients should be investigated, as the ARENA project hints at a potential benefit of population-based campaigns.

Trial registration: ClinicalTrials.gov (Identifier: NCT02978248).

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基于社区的心房颤动中风预防和公共干预效果分析：ARENA 项目的结果。

背景：基于社区的干预措施可提高人们对心房颤动（AF）相关疗法的认识和依从性，从而可能减少不良事件的发生。ARENA项目调查了德国莱茵-内卡地区心房颤动患者的健康状况、治疗方法和不良事件。子项目 "ARENA干预 "研究了社区干预对房颤相关结果的影响：从 2016 年起，ARENA 观察性登记处开始招募确诊房颤患者。2018年，启动了干预期，涉及心房颤动诊断和治疗的人群信息宣传活动。开始前招募 "对照组"，开始后招募 "干预组"。患者在招募后接受标准化随访 > 1 年。对两组患者的临床结果、治疗和生活质量进行了比较：结果：共纳入 2769 名患者。这一真实世界的队列显示，患者对口服抗凝疗法（OAC）的依从性很高，而且随着时间的推移，NOAC的使用量超过了维生素K拮抗剂。在干预组（n = 1362）中，更多患者在随访时继续使用 OAC（87.1% 对 81.5%，P = 0.002）。然而，在有 I/IIa 级 OAC 适应症的患者亚组中，这一差异并不显著（90.1% 对 87.5%，P = 0.11）。干预组心房颤动相关的再住院率较低（6.8% 对 12.3%，P 结论：量身定制的社区宣传活动可提高人们对心房颤动相关健康问题的认识，从而支持坚持治疗。ARENA项目提示了基于人群的宣传活动的潜在益处，未来应研究改善房颤患者生活质量的公共策略：试验注册：ClinicalTrials.gov（标识符：NCT02978248）。

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来源期刊

Clinical Research in Cardiology 医学-心血管系统

CiteScore

11.40

自引率

4.00%

发文量

140

审稿时长

4-8 weeks

期刊介绍： Clinical Research in Cardiology is an international journal for clinical cardiovascular research. It provides a forum for original and review articles as well as critical perspective articles. Articles are only accepted if they meet stringent scientific standards and have undergone peer review. The journal regularly receives articles from the field of clinical cardiology, angiology, as well as heart and vascular surgery. As the official journal of the German Cardiac Society, it gives a current and competent survey on the diagnosis and therapy of heart and vascular diseases.