Uptake of non-vitamin K antagonist oral anti coagulants in patients with atrial fibrillation - a prospective cohort study.

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State: Public
Version: Final published version
Serval ID
serval:BIB_D455EFBED13E
Type
Article: article from journal or magazin.
Collection
Publications
Title
Uptake of non-vitamin K antagonist oral anti coagulants in patients with atrial fibrillation - a prospective cohort study.
Journal
Swiss medical weekly
Author(s)
Zimny M., Blum S., Ammann P., Erne P., Moschovitis G., Di Valentino M., Shah D., Schläpfer J., Vogt C., Tabord A., Kühne M., Sticherling C., Osswald S., Conen D.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
21/03/2017
Peer-reviewed
Oui
Volume
147
Pages
w14410
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
We aimed to assess the uptake of non-vitamin K antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation between 2010 and 2015 in Switzerland.
We performed a prospective observational cohort study. At the baseline examination and during yearly follow-ups, we used questionnaires to obtain information about clinical characteristics and antithrombotic treatment. Stroke risk was assessed using the CHA2DS2-VASc score.
1545 patients were enrolled across seven centres in Switzerland. Mean age was 68 ± 12 years and 29.5% were female. The percentage of anticoagulated patients with an indication for oral anticoagulation (CHA2DS2-VASc score ≥2 in women and ≥1 in men) was 75% in 2010 and 80% in 2015 (p = 0.2). There was a gradual increase in the use of NOACs from 0% in 2010 to 29.8% in 2015 (p <0.0001). Out of 888 patients, who initially received a vitamin K antagonist (VKA), 86 (9.7%) were switched to an NOAC during follow-up. Use of aspirin as a monotherapy decreased from 23% in 2010 to 11% in 2015 (p <0.0001).
After regulatory approval, the use of NOACs in Switzerland steadily increased to about 30% in 2015, whereas switches from VKAs to NOACs were infrequent. In parallel, the prescription of aspirin as monotherapy was more than halved, suggesting significant guideline-concordant improvements in oral anticoagulation use among patients with atrial fibrillation.

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17/07/2017 8:48
Last modification date
20/08/2019 15:54
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