Uptake of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation – a prospective cohort study
Matylda Zimnya b, Steffen Bluma c d, Peter Ammanne, Paul Ernéf, Giorgio Moschovitisg, Marcello Di Valentinoh, Dipen C. Shahi, Jürg Schläpferj, Cyrill Vogtb, Alexandra Tabordb k, Michael Kühned l, Christian Sticherling
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Abstract
AIMS: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
TL;DRAfter regulatory approval, the use ofNOACs in Switzerland steadily increased to about 30% in 2015, whereas switches from VKAs to NOACs were infrequent, suggesting significant guideline-concordant improvements in oral anticoagulation use among patients with atrial fibrillation. (Semantic Scholar)