Influence of Direct Oral Anticoagulants on Rates of Oral Anticoagulation for Atrial Fibrillation
| Autor: | Lucas N. Marzec, Henry H. Ting, Jonathan C. Hsu, Kensey Gosch, Thomas M. Maddox, Paul S. Chan, Jingyan Wang, Nilay Shah |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Medication Therapy Management Administration Oral 030204 cardiovascular system & hematology Antithrombins Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Internal medicine Atrial Fibrillation medicine Humans Registries cardiovascular diseases 030212 general & internal medicine Practice Patterns Physicians' Oral anticoagulation Aged business.industry Warfarin Anticoagulants Atrial fibrillation Middle Aged medicine.disease Quality Improvement United States Stroke stomatognathic diseases Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine business Needs Assessment medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. 69:2475-2484 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2017.03.540 |
| Popis: | Oral anticoagulation (OAC) with warfarin is underused for atrial fibrillation (AF). The availability of direct oral anticoagulants (DOACs) may improve overall OAC rates in AF patients, but a large-scale evaluation of their effects has not been conducted.This study assessed the effect of DOAC availability on overall OAC rates for nonvalvular AF.Between April 1, 2008 and September 30, 2014, we identified 655,000 patients with nonvalvular AF and a CHAOverall OAC rates increased from 52.4% to 60.7% among eligible AF patients (p for trend 0.01). Warfarin use decreased from 52.4% to 34.8% (p for trend 0.01), and DOAC use increased from 0% to 25.8% (p for trend 0.01). An increasing CHAIntroduction of DOACs in routine practice was associated with improved rates of overall OAC use for AF, but significant gaps remain. In addition, there is significant practice-level variation in OAC and DOAC use. |
| Databáze: | OpenAIRE |
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