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Added predictive ability of the CHA2DS2VASc risk score for stroke and death in patients with atrial fibrillation: the prospective Danish Diet, Cancer, and Health cohort study.

https://arctichealth.org/en/permalink/ahliterature124928
Source
Circ Cardiovasc Qual Outcomes. 2012 May;5(3):335-42
Publication Type
Article
Date
May-2012
Author
Torben Bjerregaard Larsen
Gregory Y H Lip
Flemming Skjøth
Karen Margrete Due
Kim Overvad
Lars Hvilsted Rasmussen
Author Affiliation
Department of Cardiology, Aalborg AF Study Group, Cardiovascular Research Centre, Aarhus University Hospital, Aalborg, Denmark. tobl@rn.dk
Source
Circ Cardiovasc Qual Outcomes. 2012 May;5(3):335-42
Date
May-2012
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Anticoagulants - administration & dosage
Atrial Fibrillation - drug therapy - epidemiology - mortality
Denmark - epidemiology
Diet - adverse effects
Female
Humans
Incidence
Life Style
Male
Middle Aged
Neoplasms - epidemiology
Predictive value of tests
Prognosis
Prospective Studies
ROC Curve
Registries
Risk assessment
Risk factors
Stroke - epidemiology - mortality - prevention & control
Time Factors
Abstract
The objective of this study was to evaluate the added predictive ability of the CHA(2)DS(2)VASc prediction rule for stroke and death in a nonanticoagulated population of patients with atrial fibrillation.
We included 1603 nonanticoagulated patients with incident atrial fibrillation from a Danish prospective cohort study of 57 053 middle-aged men and women. The Net Reclassification Improvement was calculated as a measure to estimate any overall improvement in reclassification with the CHA(2)DS(2)VASc sore as an alternative to the CHADS(2) score. After 1-year follow-up, crude incidence rates were 3.4 per 100 person-years for stroke and 13.6 for death. After a mean follow-up of 5.4 years (± 3.7 years), the crude incidence rates for stroke and death were 1.9 and 5.6, respectively. During the entire observation period, the c-statistics and negative predictive values were similar for both risk scores. The Net Reclassification Improvement analysis showed that 1 of 10 reclassified atrial fibrillation patients would have been upgraded correctly using the CHA(2)DS(2)VASc score.
Both the CHADS(2) as well as the CHA(2)DS(2)VASc risk score can exclude a large proportion of patients from having high risk of stroke or death. However, using the CHA(2)DS(2)VASc risk score, fewer patients will fulfill the criterion for low risk (and are truly low risk for thromboembolism). For every 10 extra patients transferred to the treatment group at 5 years, using the CHA(2)DS(2)VASc risk score, 1 patient would have had a stroke that might have been avoided with effective treatment.
PubMed ID
22534406 View in PubMed
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[Adequacy between prescriptions and CHADS(2) score recommendations in geriatric patients].

https://arctichealth.org/en/permalink/ahliterature101701
Source
Geriatr Psychol Neuropsychiatr Vieil. 2011 Mar;9(1):39-44
Publication Type
Article
Date
Mar-2011
Author
Nolya Haïda
Marion Albouy-Llaty
Céline Baudemont
Fabienne Bellarbre
Marc Paccalin
Author Affiliation
Département de gériatrie-Pôle médecine. m.paccalin@chu-poitiers.fr
Source
Geriatr Psychol Neuropsychiatr Vieil. 2011 Mar;9(1):39-44
Date
Mar-2011
Language
French
Publication Type
Article
Keywords
Aged, 80 and over
Atrial Fibrillation - drug therapy - epidemiology
Cross-Sectional Studies
Female
Fibrinolytic Agents - adverse effects - therapeutic use
France
Guideline Adherence - statistics & numerical data
Health Status Indicators
Hemorrhage - chemically induced - epidemiology
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Retrospective Studies
Risk assessment
Stroke - epidemiology - etiology - prevention & control
Abstract
Atrial fibrillation (AF) is a major risk factor for stroke. Thromboprophylaxis with anticoagulant reduces the incidence of stroke and is warranted by the CHADS(2) recommendations when score =2. But such therapy remains underused particularly among elderly patients. The aim of our study was to evaluate the adequacy between prescriptions and CHADS(2) recommendations in geriatric hospitalised patients with AF. Method: retrospective study set in the Geriatrics Department of the University hospital of Poitiers (France), of patients >75 y with AF, between July and December 2009. The description of the patients taken into the count: epidemiological data, functional daily activities (score GIR), cognitive assessment, antithrombotic treatment, and evaluation of the CHADS(2) and HEMORR(2)HAGES scores. Results: in this study161 hospitalisations were analysed, mean age of the patients was 87.4?±?5.4 years. Antithrombotic treatment was prescribed in 84% of cases. The overall conformity to CHADS(2) recommendations was 44%. Most of hospitalisations (88.9%) included patients with CHADS(2) score =2. Non-conformity rate was up to 60% in this group with 5 significant variables: MMSE score
PubMed ID
21586375 View in PubMed
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Antiarrhythmic use from 1991 to 2007: insights from the Canadian Registry of Atrial Fibrillation (CARAF I and II).

https://arctichealth.org/en/permalink/ahliterature143905
Source
Heart Rhythm. 2010 Sep;7(9):1171-7
Publication Type
Article
Date
Sep-2010
Author
Jason G Andrade
Stuart J Connolly
Paul Dorian
Martin Green
Karin H Humphries
George J Klein
Robert Sheldon
Mario Talajic
Charles R Kerr
Author Affiliation
St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
Source
Heart Rhythm. 2010 Sep;7(9):1171-7
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology - physiopathology
Calcium Channel Blockers - therapeutic use
Canada - epidemiology
Electrocardiography - drug effects
Follow-Up Studies
Heart Rate - drug effects
Humans
Middle Aged
Morbidity - trends
Prospective Studies
Registries
Retrospective Studies
Time Factors
Treatment Outcome
Abstract
The pharmacologic management of atrial fibrillation (AF), the most common sustained cardiac arrhythmia, has been traditionally dichotomized into control of ventricular rate or re-establishment and maintenance of sinus rhythm.
The purpose of this study was to evaluate the use of rate-controlling drugs and antiarrhythmic drugs (AAD) in the Canadian Registry of Atrial Fibrillation (CARAF) over a 16-year period from 1991 through 2007.
1,400 patients with new-onset paroxysmal AF who were enrolled in CARAF were included in this analysis. We assessed trends in ventricular rate-controlling medication use (digoxin, beta-blockers, and calcium channel blockers) and AAD (class IA, IC, and III antiarrhythmic agents) at baseline and follow-up visits as well as by calendar year.
AAD use increased initially from 1991 to 1994 (peak use 42.5%) before steadily declining. Sotalol use decreased (27% to 6%), whereas amiodarone use increased (1.6% to 17.9%). Rate-controlling medication use decreased from 1991 to 1995 (54.1% to 34.1%) due to declining digoxin use (62.9% to 16.3%). After 1999, there was a continued increase in rate-controlling medication use (peak use 52.5% in 2007) due to increased beta-blocker use (17% to 45.7%). Calcium channel blockers use changed little over the duration of the study.
The management of AF has undergone significant shifts since 1990, reflecting the influence of drug development, prevailing belief systems, the impact of large clinical trials, and evidence-based recommendations. Monitoring of pharmacotherapy trends will provide insight into the real-world application of evidence-based guidelines as well as allow the opportunity to identify deficiencies and improve patient care.
PubMed ID
20430112 View in PubMed
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Anticoagulant treatment of patients with atrial fibrillation in primary health care.

https://arctichealth.org/en/permalink/ahliterature202241
Source
Scand J Prim Health Care. 1999 Mar;17(1):59-63
Publication Type
Article
Date
Mar-1999
Author
M. Viitaniemi
K. Eskola
H. Kurunmäki
A. Latva-Nevala
A M Wallin
M. Paloneva
I. Virjo
S. Ylinen
S. Ohman
M. Isokoski
Author Affiliation
Health Centre, Seinäjoki, Finland.
Source
Scand J Prim Health Care. 1999 Mar;17(1):59-63
Date
Mar-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology
Child
Child, Preschool
Cross-Sectional Studies
Family Practice - statistics & numerical data
Female
Finland - epidemiology
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Middle Aged
Prevalence
Quality of Health Care
Abstract
To determine the prevalence of anticoagulant (AC) treatment of patients with atrial fibrillation in primary health care. To identify complications in the same patients during 1 year.
Cross-sectional study and 1-year follow-up.
Seven health centres with a total population of 164093.
Five hundred and twenty-two anticoagulated patients with atrial fibrillation.
The age-adjusted prevalence of AC treated patients with atrial fibrillation was 0.30%. Of the 522 patients, 240 were men, mean age 69.6 years; and 282 women, mean age 75.1 years. At the beginning of the study 85% and after 1 year 81% of the latest prothrombin time values were within recommended range. After 1 year 414 out of the 522 patients continued AC treatment. During the 1-year follow-up 62 patients had minor or major complications. Eleven patients (2.1%) had to discontinue AC treatment because of complications. Prothrombin tests were mainly taken at 3-4 week intervals.
High quality AC treatment is possible in the hands of general practitioners.
PubMed ID
10229996 View in PubMed
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Anticoagulant treatment of patients with chronic atrial fibrillation in primary health care in Sweden--a retrospective study of incidence and quality in a registered population.

https://arctichealth.org/en/permalink/ahliterature51950
Source
Fam Pract. 2004 Dec;21(6):612-6
Publication Type
Article
Date
Dec-2004
Author
Gunnar H Nilsson
Ingela Björholt
Ingvar Krakau
Author Affiliation
Department of Clinical Sciences, Center of Family Medicine, Karolinska Institute, Stockholm, Sweden. gunnar.nilsson@nlpo.sll.se
Source
Fam Pract. 2004 Dec;21(6):612-6
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anticoagulants - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology
Chronic Disease
Cohort Studies
Community health centers - standards
Drug Utilization Review
Female
Humans
Incidence
Linear Models
Male
Medical Records Systems, Computerized
Middle Aged
Prevalence
Primary Health Care - standards
Quality of Health Care
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Time Factors
Warfarin - therapeutic use
Abstract
BACKGROUND: The number of patients receiving anticoagulant treatment is increasing. Chronic atrial fibrillation is the most common treatment diagnosis. The literature indicates a variable level of treatment control. Estimates of time within the therapeutic range have been recommended as a measurement of quality. Electronic patient records are providing clinical data that are useful for audits concerning anticoagulant treatment in real-life practice. OBJECTIVE: Our aim was to assess warfarin treatment for chronic atrial fibrillation in primary health care with regard to prevalence, incidence and quality. METHODS: A 2 year retrospective study was carried out of electronic patient records up to April 2002 in primary health care in Stockholm, including 12 primary health care centres with a registered population of 203 407. Main outcome measures were the number of new patients on wafarin treatment for chronic atrial fibrillation, and time within the therapeutic prothrombin range in the first 90 days of treatment using a linear interpolation method. RESULTS: In total, 827 patients were on warfarin treatment for chronic atrial fibrillation, giving a prevalence of 0.41%. Of these, 144 patients (study group) started treatment with warfarin for chronic atrial fibrillation during the study period, giving a yearly incidence of 0.07%. Their mean age was 73.1 years and 61.1% were men. There were 1721 prothrombin monitoring episodes registered in the first 90 days of treatment, on average once a week per patient. The average proportion of time within the therapeutic range was 54.1% (95% confidence interval (CI) 50.1-58.1), and the proportion of therapeutic tests was 50.2% (95% CI 47.8-52.6). CONCLUSIONS: During the first, second and third months of warfarin treatment for chronic atrial fibrillation, patients were outside the therapeutic range time nearly half the time. There was a gender difference favouring men regarding initiation of treatment.
PubMed ID
15465879 View in PubMed
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Anticoagulation for atrial fibrillation and stroke prevention.

https://arctichealth.org/en/permalink/ahliterature55053
Source
Neuroepidemiology. 1993;12(5):280-4
Publication Type
Article
Date
1993
Author
G. Boysen
Author Affiliation
Department of Neurology, Hvidovre Hospital, University of Copenhagen, Denmark.
Source
Neuroepidemiology. 1993;12(5):280-4
Date
1993
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Anticoagulants - therapeutic use
Aspirin - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology - prevention & control
Cerebrovascular Disorders - drug therapy - epidemiology - prevention & control
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Prevalence
Primary Prevention
Risk factors
Abstract
Nonvalvular atrial fibrillation (NVAF) has a prevalence of about 1% in the 60- to 70-year age group, increasing to above 4% in persons older than 80 years. The yearly stroke incidence in NVAF patients is 3-8%, which is 5-7 times higher than that in age-matched persons in sinus rhythm. In five independent studies of stroke prevention in NVAF patients, anticoagulation therapy resulted in a risk reduction of stroke of about 65%. The risk of intracerebral hemorrhage was 0.3% per year during warfarin therapy compared with 0.1% in the placebo group. In one study aspirin reduced the risk of thromboembolic events by 42% while another study found a nonsignificant effect of aspirin. The following variables were identified as risk factors for stroke in the individual studies: prior myocardial infarction, increasing age, mitral annular calcification, history of hypertension, congestive heart failure and previous arterial thromboembolism. A pooled analysis of risk factors in the placebo-treated patients of the five studies is ongoing.
PubMed ID
8309503 View in PubMed
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Antithrombotic therapy in patients with non-valvular atrial fibrillation in Southern Sweden: A population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature278106
Source
Thromb Res. 2016 Apr;140:94-9
Publication Type
Article
Date
Apr-2016
Author
Natalia Mochalina
Anna Jöud
Maj Carlsson
Maria E C Sandberg
Anders Själander
Tord Juhlin
Peter J Svensson
Source
Thromb Res. 2016 Apr;140:94-9
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Aspirin - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology
Cohort Studies
Female
Humans
Male
Middle Aged
Risk factors
Stroke - drug therapy - epidemiology
Sweden
Treatment Outcome
Warfarin - therapeutic use
Abstract
Oral anticoagulants in patients with atrial fibrillation (AF) with moderate-to-high stroke risk are strongly recommended by the current guidelines.
Population-based register study of all 13,837 patients with incident non-valvular AF diagnosed during 2011-2014 in primary and secondary care (including all in- and outpatient visits) in Skåne County, Sweden. The outcome was the prescription of direct-acting oral anticoagulants (DOAC), warfarin or acetylsalicylic acid (ASA).
Guideline adherence increased from 47.6% in 2011 to 66.1% in 2014, mostly due to decrease in undertreatment. In patients with CHA2DS2-VASc score = 2, ASA uptake decreased from 29.9% to 14.7% and DOAC uptake increased from 2.1% to 25.1%. The use of ASA was more common among elderly and with increasing stroke- and bleeding risk. Overall, 47.4% of patients with CHA2DS2-VASc score = 2 did not receive oral anticoagulants. Undertreatment was particularly common in women 84 years (65.3% in women and 62% in men). Overtreatment of patients at low stroke risk was 35.9% in men and 36.4% in women. Provider speciality affected the choice of treatment only to a minor degree. Despite increasing guideline adherence, there is a suboptimal use of antithrombotic therapy in a large proportion of AF patients diagnosed in different clinical settings. Efforts to further improve guideline adherence should particularly be targeted on women 84 years and patients at low stroke risk.
PubMed ID
26938155 View in PubMed
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Atrial fibrillation and antithrombotic therapy in a 75-year-old population.

https://arctichealth.org/en/permalink/ahliterature87386
Source
Cardiology. 2008;109(4):258-62
Publication Type
Article
Date
2008
Author
Tveit Arnljot
Abdelnoor Michael
Enger Steve
Smith Pal
Author Affiliation
Department of Internal Medicine, Asker and Baerum Hospital, Rud, Norway. arnljot.tveit@broadpark.no
Source
Cardiology. 2008;109(4):258-62
Date
2008
Language
English
Publication Type
Article
Keywords
Aged
Atrial Fibrillation - drug therapy - epidemiology
Electrocardiography
Female
Fibrinolytic Agents - therapeutic use
Humans
Male
Norway - epidemiology
Prevalence
Treatment Outcome
Abstract
AIMS: To find the true prevalence of diagnosed and undiagnosed atrial fibrillation (AF) in a population aged 75 years in 2 municipalities in Norway, and to study the use of antithrombotic therapy in this group. METHODS: All 1,117 citizens in Asker and Baerum municipalities in eastern Norway born in 1930 were invited to participate in a prevalence study of AF. Nine hundred and sixteen subjects (82%) were examined by electrocardiogram, and blood pressure and pulse rate were measured. Comorbidity and current medication were recorded. RESULTS: AF was present in 92 subjects (10%; 95% CI 8.2-12.1%), including 33 with ECG-documented, paroxysmal AF. In addition, 8 subjects had a history of a single, transient episode of AF. AF was previously undiagnosed in 10 out of 916 (1.1%). In 77 of 82 patients with previously diagnosed AF (93.9%), antithrombotic therapy was compliant with international guidelines. CONCLUSION: Ten percent (95% CI 8.2-12.2%) in this 75-year-old population had AF. Compliance with international guidelines regarding antithrombotic therapy was high. Previously undiagnosed AF was found in only 10 out of 916 (1.1%).
PubMed ID
17873490 View in PubMed
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Characterization of patients with atrial fibrillation not treated with oral anticoagulants.

https://arctichealth.org/en/permalink/ahliterature263161
Source
Scand J Prim Health Care. 2014 Dec;32(4):226-31
Publication Type
Article
Date
Dec-2014
Author
Cecilia Johansson
Lovisa Hägg
Lars Johansson
Jan-Håkan Jansson
Source
Scand J Prim Health Care. 2014 Dec;32(4):226-31
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants - administration & dosage - adverse effects - therapeutic use
Atrial Fibrillation - drug therapy - epidemiology
Cardiovascular Diseases - drug therapy
Child
Child, Preschool
Cross-Sectional Studies
Female
Guideline Adherence
Humans
Infant
Infant, Newborn
Male
Middle Aged
Retrospective Studies
Risk factors
Sweden - epidemiology
Young Adult
Abstract
An underuse of oral anticoagulants (OAC) in patients with atrial fibrillation (AF) has been suggested, as only 50% of all patients with AF receive OAC treatment. Whether this is due to contraindications, lack of an indication to treat, or an expression of underuse is sparsely investigated. This study therefore aimed to characterize individuals without OAC treatment in a real-life population of patients with AF.
Retrospective cross-sectional study. The medical records were scrutinized in order to identify the type of AF, risk factors for embolism and bleeding, and other factors of importance for OAC treatment.
The municipalities of Skellefteå and Norsjö, northern Sweden.
A total of 2274 living residents with at least one verified episode of AF on or before December 31, 2010.
Prevalence of treatment with OAC and documented reasons to withhold OAC treatment.
Among all 2274 patients with AF, 1187 (52%) were not treated with OAC. Of the untreated patients, 19% had no indication or had declined or had experienced adverse effects other than bleeding on warfarin treatment. The most common reason to withhold OAC was presence of risk factors for bleeding, found in 38% of all untreated patients. Furthermore, a documented reason could be identified to withhold OAC in 75%.
Among patients with AF without OAC treatment a reason could be identified to withhold OAC in 75%. The underuse of OAC is estimated to be 25%.
Notes
Cites: Am J Med. 2010 Jul;123(7):638-645.e420609686
Cites: Europace. 2010 Oct;12(10):1360-42020876603
Cites: Ther Drug Monit. 2011 Aug;33(4):433-821743381
Cites: Chest. 2011 Oct;140(4):918-2421511826
Cites: Heart. 2011 Dec;97(24):2046-5022076011
Cites: BMC Fam Pract. 2012;13:522304704
Cites: Eur Heart J. 2012 Jun;33(12):1500-1022246443
Cites: J Intern Med. 2012 Aug;272(2):170-622250988
Cites: Scand J Prim Health Care. 2012 Sep;30(3):169-7522830533
Cites: Eur Heart J. 2012 Nov;33(21):2719-4722922413
Cites: Am Heart J. 2013 Jan;165(1):93-101.e123237139
Cites: Circulation. 2013 Feb 26;127(8):930-723343564
Cites: Scand J Prim Health Care. 2013 Jun;31(2):73-823621352
Cites: Thromb Haemost. 2013 Aug;110(2):213-2223595785
Cites: J Intern Med. 2013 Nov;274(5):461-823879838
Cites: Stroke. 2013 Nov;44(11):3103-823982711
Cites: Eur J Intern Med. 2013 Dec;24(8):800-624035703
Cites: JAMA. 2001 Jun 13;285(22):2864-7011401607
Cites: Eur Heart J. 2006 Aug;27(16):1954-6416847008
Cites: Scand J Prim Health Care. 2007 Jun;25(2):123-817497491
Cites: Ann Intern Med. 2007 Jun 19;146(12):857-6717577005
Cites: Am J Cardiovasc Drugs. 2010;10(1):37-4820104933
Cites: Chest. 2010 Feb;137(2):263-7219762550
PubMed ID
25464863 View in PubMed
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Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature280433
Source
BMJ. 2016 Jun 16;353:i3189
Publication Type
Article
Date
Jun-16-2016
Author
Torben Bjerregaard Larsen
Flemming Skjøth
Peter Brønnum Nielsen
Jette Nordstrøm Kjældgaard
Gregory Y H Lip
Source
BMJ. 2016 Jun 16;353:i3189
Date
Jun-16-2016
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Aged, 80 and over
Anticoagulants - administration & dosage - adverse effects
Atrial Fibrillation - drug therapy - epidemiology
Cohort Studies
Dabigatran - administration & dosage - adverse effects
Denmark - epidemiology
Drug Administration Schedule
Embolism - epidemiology - prevention & control
Female
Hemorrhage - chemically induced - epidemiology
Humans
Male
Propensity Score
Pyrazoles - administration & dosage - adverse effects
Pyridones - administration & dosage - adverse effects
Registries
Rivaroxaban - administration & dosage - adverse effects
Stroke - epidemiology - prevention & control
Treatment Outcome
Warfarin - administration & dosage - adverse effects
Abstract
 To study the effectiveness and safety of the non-vitamin K antagonist oral anticoagulants (novel oral anticoagulants, NOACs) dabigatran, rivaroxaban, and apixaban compared with warfarin in anticoagulant naïve patients with atrial fibrillation.
 Observational nationwide cohort study.
 Three Danish nationwide databases, August 2011 to October 2015.
 61?678 patients with non-valvular atrial fibrillation who were naïve to oral anticoagulants and had no previous indication for valvular atrial fibrillation or venous thromboembolism. The study population was distributed according to treatment type: warfarin (n=35?436, 57%), dabigatran 150 mg (n=12?701, 21%), rivaroxaban 20 mg (n=7192, 12%), and apixaban 5 mg (n=6349, 10%).
 Effectiveness outcomes defined a priori were ischaemic stroke; a composite of ischaemic stroke or systemic embolism; death; and a composite of ischaemic stroke, systemic embolism, or death. Safety outcomes were any bleeding, intracranial bleeding, and major bleeding.
 When the analysis was restricted to ischaemic stroke, NOACs were not significantly different from warfarin. During one year follow-up, rivaroxaban was associated with lower annual rates of ischaemic stroke or systemic embolism (3.0% v 3.3%, respectively) compared with warfarin: hazard ratio 0.83 (95% confidence interval 0.69 to 0.99). The hazard ratios for dabigatran and apixaban (2.8% and 4.9% annually, respectively) were non-significant compared with warfarin. The annual risk of death was significantly lower with apixaban (5.2%) and dabigatran (2.7%) (0.65, 0.56 to 0.75 and 0.63, 0.48 to 0.82, respectively) compared with warfarin (8.5%), but not with rivaroxaban (7.7%). For the combined endpoint of any bleeding, annual rates for apixaban (3.3%) and dabigatran (2.4%) were significantly lower than for warfarin (5.0%) (0.62, 0.51 to 0.74). Warfarin and rivaroxaban had comparable annual bleeding rates (5.3%).
 All NOACs seem to be safe and effective alternatives to warfarin in a routine care setting. No significant difference was found between NOACs and warfarin for ischaemic stroke. The risks of death, any bleeding, or major bleeding were significantly lower for apixaban and dabigatran compared with warfarin.
Notes
Cites: Europace. 2012 Oct;14(10):1385-41322923145
Cites: Stroke. 2015 Sep;46(9):2555-6126304863
Cites: Thromb Haemost. 2014 May 5;111(5):789-9724500243
Cites: Ann Intern Med. 2007 Jun 19;146(12):857-6717577005
Cites: J Intern Med. 2015 Jul;278(1):1-1825758241
Cites: N Engl J Med. 2013 Nov 28;369(22):2093-10424251359
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):22-521775345
Cites: Am Heart J. 2010 Oct;160(4):635-4120934556
Cites: Stat Med. 1999 Mar 30;18(6):695-70610204198
Cites: J Intern Med. 2014 Jun;275(6):570-8024520806
Cites: BMJ. 2016 Feb 03;352:i57526843102
Cites: Chest. 2010 Nov;138(5):1093-10020299623
Cites: N Engl J Med. 2011 Mar 3;364(9):806-1721309657
Cites: N Engl J Med. 2009 Sep 17;361(12):1139-5119717844
Cites: Eur Heart J. 2016 Feb 4;:null26848149
Cites: Lancet. 2014 Mar 15;383(9921):955-6224315724
Cites: Int J Clin Pract. 2015 Nov;69(11):1341-826234557
Cites: Biom J. 2009 Feb;51(1):171-8419197955
Cites: N Engl J Med. 2011 Sep 15;365(11):981-9221870978
Cites: N Engl J Med. 2016 Feb 25;374(8):785-826839968
Cites: Am J Med. 2010 Sep;123(9):785-920655037
Cites: Europace. 2015 Feb;17(2):187-9325236181
Cites: Epidemiology. 2000 Sep;11(5):550-6010955408
Cites: Europace. 2015 Oct;17(10):1467-50726324838
Cites: N Engl J Med. 2011 Sep 8;365(10):883-9121830957
Cites: Clin Pharmacol Ther. 2011 Dec;90(6):777-9022048230
Cites: Stat Med. 2013 Aug 30;32(19):3388-41423508673
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):30-321775347
Cites: Neuroepidemiology. 2007;28(3):150-417478969
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):38-4121775349
PubMed ID
27312796 View in PubMed
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29 records – page 1 of 3.