Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life
| Autor: | Maria Cristina Vedovati, Federica Cianella, Cecilia Becattini, Melina Verso, Michela Giustozzi, Giancarlo Agnelli, Serenella Conti, Lucia Pierpaoli, Esmeralda Filippucci, Paolo Verdecchia, Emanuela Marchesini |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Vitamin K medicine.drug_class Pyridones Administration Oral Hemorrhage 030204 cardiovascular system & hematology Non-valvular atrial fibrillation Non-vitamin K antagonist oral anticoagulants Vitamin-K antagonists Internal Medicine Severity of Illness Index Dabigatran 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Rivaroxaban Internal medicine Severity of illness Atrial Fibrillation medicine Humans 030212 general & internal medicine Aged Aged 80 and over business.industry Antagonist Anticoagulants Atrial fibrillation Vitamin K antagonist Middle Aged medicine.disease Logistic Models Italy Cardiology Pyrazoles Apixaban Female business Fibrinolytic agent medicine.drug |
| Popis: | Current guidelines recommend vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with non-valvular atrial fibrillation (AF).We compared the clinical features of consecutive in- and out-patients with non-valvular AF newly-treated with NOACs or on treatment with VKAs.Overall, 1314 patients newly-treated with NOACs and 1024 on treatment with VKAs were included in the study. The mean CHA2DS2-VASc score was 4.3±1.5 and 4.0±1.5 and the mean HAS-BLED score was 2.8±1.2 and 2.2±1.1 in the two groups, respectively (both p0.001). Hypertension, previous stroke, female gender, vascular diseases and previous bleeding were more prevalent in NOACs patients. Renal failure, age ≥75years and congestive heart failure were more prevalent in VKAs patients. Among NOACs patients, 438 were given dabigatran, 463 rivaroxaban and 413 apixaban (33%, 35% and 31%, respectively). The mean CHA2DS2-VASc and HAS-BLED scores were higher in rivaroxaban or apixaban patients compared with dabigatran (both p0.001) and VKAs patients (both p0.001). A lower mean age was observed in patients newly-treated with dabigatran. Patients newly-treated with reduced doses of NOACs (599 patients, 45.5%) had a higher CHA2DS2-VASc (4.8±1.4 vs. 3.9±1.5 vs. 4.0±1.5) and HAS-BLED (2.9±1.1 vs. 2.8±1.2 vs. 2.2±1.1) scores compared with those treated with regular doses of NOACs or VKAs.Patients given rivaroxaban and apixaban in clinical practice have a higher thrombotic and hemorrhagic risk in comparison with patients given dabigatran or VKAs. A considerable proportion of patients receive reduced doses of NOACs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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