{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T09:40:12Z","timestamp":1766137212994},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":65,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TH Open"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>\n            Background\u2003Valvular heart disease (VHD) and atrial fibrillation (AF) often coexist.<\/jats:p><jats:p>\n            Aim\u2003We investigated whether type 2 VHD (other than moderate-severe rheumatic mitral stenosis or mechanical heart valve) influences the prescription of anticoagulants in AF.<\/jats:p><jats:p>\n            Methods\u2003Umbria-Fibrillazione Atriale is a prospective multicenter registry in patients with AF. For the purpose of this study, type 2 VHD patients were propensity matched with non-VHD counterparts in a 1:1 ratio. Patients with type 1 VHD (moderate-severe mitral stenosis or mechanical heart valve) were excluded.<\/jats:p><jats:p>\n            Results\u2003We identified 2,212 patients with AF and excluded 46 because data on VHD were unavailable. Type 2 VHD was present in 426 patients (19.7%). Before registry entry visit, 77.1% of type 2 VHD and 66.8% of non-VHD patients were on anticoagulants. At discharge, 90.8 and 85.2% of patients, respectively, were on anticoagulants. After propensity-score matching, 386 patient-pairs were created. In the matched sample, the likelihood of being on anticoagulants before (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.02\u20132.01, p\u2009=\u20090.036) and after (1.63, 95% CI: 1.04\u20132.57, p\u2009=\u20090.034) the entry visit was higher in type 2 VHD than in non-VHD patients. Patients with type 2 VHD were 70% more likely to receive vitamin K antagonists (VKAs) (OR: 1.70, 95% CI: 1.28\u20132.27, p\u2009&lt;\u20090.001), and 32% less likely to receive non\u2013vitamin K oral anticoagulants (NOACs; OR: 0.68, 95% CI: 049\u20130.94, p\u2009=\u20090.011) than non-VHD patients.<\/jats:p><jats:p>\n            Conclusion\u2003VKAs consistently outperformed NOACs as preferred treatment option in patients with type 2 VHD. This could potentially deny to these patients the well-established benefits of NOACs observed in phase III trials.<\/jats:p>","DOI":"10.1055\/s-0039-1692202","type":"journal-article","created":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T19:04:55Z","timestamp":1559761495000},"page":"e157-e164","source":"Crossref","is-referenced-by-count":2,"title":["Type 2 Valvular Heart Disease Affects Decision Making for Anticoagulation in Patients with Atrial Fibrillation: The UMBRIA-Fibrillazione Atriale Prospective Study"],"prefix":"10.1055","volume":"03","author":[{"given":"Maria Cristina","family":"Vedovati","sequence":"additional","affiliation":[{"name":"Vascular and Emergency Medicine - Stroke Unit, University of Perugia, Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpaolo","family":"Reboldi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Perugia, Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Agnelli","sequence":"additional","affiliation":[{"name":"Vascular and Emergency Medicine - Stroke Unit, University of Perugia, Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Verdecchia","sequence":"additional","affiliation":[{"name":"Fondazione Umbra Cuore e Ipertensione-ONLUS, Ospedale S. Maria Della Misericordia, Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on Behalf of the Umbria-Fibrillazione Atriale Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,6,5]]},"container-title":["TH Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1692202.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T19:04:55Z","timestamp":1559761495000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1692202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":0,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2019,4,17]]},"published-print":{"date-parts":[[2019,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1692202","relation":{},"ISSN":["2512-9465"],"issn-type":[{"type":"electronic","value":"2512-9465"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}