Article ; Online: Patterns and outcomes of switching direct oral anticoagulants in non-valvular atrial fibrillation: A real-world experience from Spain.
Revista clinica espanola
2023 Volume 223, Issue 6, Page(s) 340–349
Abstract: Aims: The aim is to evaluate a management program for direct oral anticoagulants (DOACs) in non-valvular atrial fibrillation (NVAF) patients according to their profiles, appropriateness of dosing, patterns of crossover, effectiveness and safety. This is ...
| Abstract | Aims: The aim is to evaluate a management program for direct oral anticoagulants (DOACs) in non-valvular atrial fibrillation (NVAF) patients according to their profiles, appropriateness of dosing, patterns of crossover, effectiveness and safety. This is an observational and longitudinal prospective study in a cohort of patients attended in daily clinical practice in a regional hospital in Spain with 3-year a follow-up plan for patients initiating dabigatran, rivaroxaban or apixaban between JAN/2012-DEC/2016. Methods: We analyzed 490 episodes of treatment (apixaban 2.5 9.4%, apixaban 5 21.4%, dabigatran 75 0.6%, dabigatran 110 12,4%, dabigatran 150 19.8%, rivaroxaban 15 17.8% and rivaroxaban 20 18.6%) in 445 patients. 13.6% of patients on dabigatran, 9.7% on rivaroxaban, and 3.9% on apixaban switched to other DOACs or changed dosing. Results: Apixaban was the most frequent DOAC switched to. The most frequent reasons for switching were toxicity (23.8%), bleeding (21.4%) and renal deterioration (16.7%). Inappropriateness of dose was found in 23.8% of episodes. Rates of stroke/transient ischemic attack (TIA) were 1.64/0.54 events/100 patients-years, while rates of major, clinically relevant non-major (CRNM) bleeding and intracranial bleeding were 2.4, 5, and 0.5 events/100 patients-years. Gastrointestinal and genitourinary bleeding were the most common type of bleeding events (BE). On multivariable analysis, prior stroke and age were independent predictors of stroke/TIA. Concurrent platelet inhibitors, male gender and age were independent predictors of BE. Conclusion: This study complements the scant data available on the use of DOACs in NVAF patients in Spain, confirming a good safety and effectiveness profile. |
|---|---|
| MeSH term(s) | Humans ; Male ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/chemically induced ; Rivaroxaban/adverse effects ; Dabigatran/adverse effects ; Anticoagulants/adverse effects ; Ischemic Attack, Transient/chemically induced ; Ischemic Attack, Transient/drug therapy ; Prospective Studies ; Spain ; Stroke/prevention & control ; Stroke/chemically induced ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Hemorrhage/drug therapy ; Retrospective Studies |
| Chemical Substances | Rivaroxaban (9NDF7JZ4M3) ; Dabigatran (I0VM4M70GC) ; Anticoagulants |
| Language | English |
| Publishing date | 2023-04-25 |
| Publishing country | Spain |
| Document type | Observational Study ; Journal Article |
| ISSN | 2254-8874 |
| ISSN (online) | 2254-8874 |
| DOI | 10.1016/j.rceng.2023.04.005 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
Full text online
More links
Kategorien
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.
Inter-library loan at ZB MED
Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.