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Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry
Background: Current guidelines do not suggest in which groups of patients with atrial fibrillation (AF) individual non-vitamin K antagonist oral anticoagulants (NOACs) should be used for the prevention of thromboembolic complications. The aim of this study was to evaluate the frequency of use of api...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694480/ https://www.ncbi.nlm.nih.gov/pubmed/33167503 http://dx.doi.org/10.3390/jcm9113565 |
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author | Gorczyca, Iwona Jelonek, Olga Uziębło-Życzkowska, Beata Chrapek, Magdalena Maciorowska, Małgorzata Wójcik, Maciej Błaszczyk, Robert Kapłon-Cieślicka, Agnieszka Gawałko, Monika Budnik, Monika Tokarek, Tomasz Rajtar-Salwa, Renata Bil, Jacek Wojewódzki, Michał Szpotowicz, Anna Bednarski, Janusz Bakuła-Ostalska, Elwira Tomaszuk-Kazberuk, Anna Szyszkowska, Anna Wełnicki, Marcin Mamcarz, Artur Wożakowska-Kapłon, Beata |
author_facet | Gorczyca, Iwona Jelonek, Olga Uziębło-Życzkowska, Beata Chrapek, Magdalena Maciorowska, Małgorzata Wójcik, Maciej Błaszczyk, Robert Kapłon-Cieślicka, Agnieszka Gawałko, Monika Budnik, Monika Tokarek, Tomasz Rajtar-Salwa, Renata Bil, Jacek Wojewódzki, Michał Szpotowicz, Anna Bednarski, Janusz Bakuła-Ostalska, Elwira Tomaszuk-Kazberuk, Anna Szyszkowska, Anna Wełnicki, Marcin Mamcarz, Artur Wożakowska-Kapłon, Beata |
author_sort | Gorczyca, Iwona |
collection | PubMed |
description | Background: Current guidelines do not suggest in which groups of patients with atrial fibrillation (AF) individual non-vitamin K antagonist oral anticoagulants (NOACs) should be used for the prevention of thromboembolic complications. The aim of this study was to evaluate the frequency of use of apixaban, dabigatran, and rivaroxaban, and attempt to identify factors predisposing their administration. Methods: The Polish Atrial Fibrillation (POL-AF) registry is a prospective, non-interventional study, including consecutive patients with AF hospitalized in ten Polish cardiology centers during the period ranging from January to December 2019. In this study, all patients were treated with NOACs. Results: Among the 2971 patients included in the analysis, 40.4% were treated with rivaroxaban, 32% with apixaban, and 27.6% with dabigatran. The mean age of the total population was 72 ± 11.5 years and 43% were female. A reduced dose of NOAC was used in 35% of patients treated with apixaban, 39.7% of patients treated with dabigatran, and 34.4% of patients treated with rivaroxaban. Independent predictors of the use of apixaban were previous bleeding (OR 2.37, CI 1.67–3.38), GFR < 60 mL/min (OR 1.38, CI 1.25–1.64), heart failure (OR 1.38, CI 1.14–1.67) and age (per 5 years) (OR 1.14, CI 1.09–1.19). GFR < 60 mL/min (OR 0.79, CI 0.66–0.95), female (OR 0.8, CI 0.67–0.96) and age (per 5 years) (OR 0.95, CI 0.91–0.99) diminished the chance of using dabigatran. Previous bleeding (OR 0.43, CI 0.28–0.64), vascular disease (OR 0.84, CI 0.70–0.99), and age (per 5 years) (OR 0.94, CI 0.90–0.97) diminished the chance of choosing rivaroxaban. Conclusions: In hospitalized patients with AF, the most frequently chosen NOAC was rivaroxaban. Apixaban was chosen more often in patients after bleeding, and in those who were advanced in years, with heart failure and impaired renal function. Impaired renal function and female gender were factors that diminished the chance of using dabigatran. Previous bleeding and vascular disease was the factor that diminished the chance of using rivaroxaban. Dabigatran and rivaroxaban have been used less frequently in elderly patients. |
format | Online Article Text |
id | pubmed-7694480 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-76944802020-11-28 Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry Gorczyca, Iwona Jelonek, Olga Uziębło-Życzkowska, Beata Chrapek, Magdalena Maciorowska, Małgorzata Wójcik, Maciej Błaszczyk, Robert Kapłon-Cieślicka, Agnieszka Gawałko, Monika Budnik, Monika Tokarek, Tomasz Rajtar-Salwa, Renata Bil, Jacek Wojewódzki, Michał Szpotowicz, Anna Bednarski, Janusz Bakuła-Ostalska, Elwira Tomaszuk-Kazberuk, Anna Szyszkowska, Anna Wełnicki, Marcin Mamcarz, Artur Wożakowska-Kapłon, Beata J Clin Med Article Background: Current guidelines do not suggest in which groups of patients with atrial fibrillation (AF) individual non-vitamin K antagonist oral anticoagulants (NOACs) should be used for the prevention of thromboembolic complications. The aim of this study was to evaluate the frequency of use of apixaban, dabigatran, and rivaroxaban, and attempt to identify factors predisposing their administration. Methods: The Polish Atrial Fibrillation (POL-AF) registry is a prospective, non-interventional study, including consecutive patients with AF hospitalized in ten Polish cardiology centers during the period ranging from January to December 2019. In this study, all patients were treated with NOACs. Results: Among the 2971 patients included in the analysis, 40.4% were treated with rivaroxaban, 32% with apixaban, and 27.6% with dabigatran. The mean age of the total population was 72 ± 11.5 years and 43% were female. A reduced dose of NOAC was used in 35% of patients treated with apixaban, 39.7% of patients treated with dabigatran, and 34.4% of patients treated with rivaroxaban. Independent predictors of the use of apixaban were previous bleeding (OR 2.37, CI 1.67–3.38), GFR < 60 mL/min (OR 1.38, CI 1.25–1.64), heart failure (OR 1.38, CI 1.14–1.67) and age (per 5 years) (OR 1.14, CI 1.09–1.19). GFR < 60 mL/min (OR 0.79, CI 0.66–0.95), female (OR 0.8, CI 0.67–0.96) and age (per 5 years) (OR 0.95, CI 0.91–0.99) diminished the chance of using dabigatran. Previous bleeding (OR 0.43, CI 0.28–0.64), vascular disease (OR 0.84, CI 0.70–0.99), and age (per 5 years) (OR 0.94, CI 0.90–0.97) diminished the chance of choosing rivaroxaban. Conclusions: In hospitalized patients with AF, the most frequently chosen NOAC was rivaroxaban. Apixaban was chosen more often in patients after bleeding, and in those who were advanced in years, with heart failure and impaired renal function. Impaired renal function and female gender were factors that diminished the chance of using dabigatran. Previous bleeding and vascular disease was the factor that diminished the chance of using rivaroxaban. Dabigatran and rivaroxaban have been used less frequently in elderly patients. MDPI 2020-11-05 /pmc/articles/PMC7694480/ /pubmed/33167503 http://dx.doi.org/10.3390/jcm9113565 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gorczyca, Iwona Jelonek, Olga Uziębło-Życzkowska, Beata Chrapek, Magdalena Maciorowska, Małgorzata Wójcik, Maciej Błaszczyk, Robert Kapłon-Cieślicka, Agnieszka Gawałko, Monika Budnik, Monika Tokarek, Tomasz Rajtar-Salwa, Renata Bil, Jacek Wojewódzki, Michał Szpotowicz, Anna Bednarski, Janusz Bakuła-Ostalska, Elwira Tomaszuk-Kazberuk, Anna Szyszkowska, Anna Wełnicki, Marcin Mamcarz, Artur Wożakowska-Kapłon, Beata Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry |
title | Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry |
title_full | Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry |
title_fullStr | Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry |
title_full_unstemmed | Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry |
title_short | Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry |
title_sort | trends in the prescription of non-vitamin k antagonist oral anticoagulants for atrial fibrillation: results of the polish atrial fibrillation (pol-af) registry |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694480/ https://www.ncbi.nlm.nih.gov/pubmed/33167503 http://dx.doi.org/10.3390/jcm9113565 |
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