Current Anticoagulant Usage Patterns and Determinants in Korean Patients with Nonvalvular Atrial Fibrillation
Yonsei Medical Journal
;
: 120-128, 2020.
Artículo
en Inglés
| WPRIM
| ID: wpr-782200
ABSTRACT
PURPOSE: Stroke prevention in patients with atrial fibrillation (AF) is influenced by many factors. Using a contemporary registry, we evaluated variables associated with the use of warfarin or direct oral anticoagulants (OACs).MATERIALS AND METHODS:
In the prospective multicenter CODE-AF registry, 10529 patients with AF were evaluated. Multivariate analyses were performed to identify variables associated with the use of anticoagulants.RESULTS:
The mean age of the patients was 66.9±14.4 years, and 64.9% were men. The mean CHA2DS2-VASc and HAS-BLED scores were 2.6±1.7 and 1.8±1.1, respectively. In patients with high stroke risk (CHA2DS2-VASc ≥2), OACs were used in 83.2%, including direct OAC in 68.8%. The most important factors for non-OAC treatment were end-stage renal disease [odds ratio (OR) 0.27; 95% confidence interval (CI) 0.19–0.40], myocardial infarct (OR 0.53; 95% CI 0.40–0.72), and major bleeding (OR 0.57; 95% CI 0.39–0.84). Female sex (OR 1.40; 95% CI 1.21–1.61), cancer (OR 1.78; 95% CI 1.38–2.29), and smoking (OR 1.60; 95% CI 1.15–2.24) were factors favoring direct OAC use over warfarin. Among patients receiving OACs, the rate of combined antiplatelet agents was 7.8%. However, 73.6% of patients did not have any indication for a combination of antiplatelet agents.CONCLUSION:
Renal disease and history of valvular heart disease were associated with warfarin use, while cancer and smoking status were associated with direct OAC use in high stroke risk patients. The combination of antiplatelet agents with OAC was prescribed in 73.6% of patients without definite indications recommended by guidelines.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Fibrilación Atrial
/
Humo
/
Warfarina
/
Inhibidores de Agregación Plaquetaria
/
Fumar
/
Análisis Multivariante
/
Estudios Prospectivos
/
Accidente Cerebrovascular
/
Enfermedades de las Válvulas Cardíacas
/
Hemorragia
Tipo de estudio:
Ensayo Clínico Controlado
/
Guía de Práctica Clínica
/
Estudio observacional
/
Estudio pronóstico
Límite:
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Yonsei Medical Journal
Año:
2020
Tipo del documento:
Artículo
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