Changes in anticoagulant prescription patterns over time for patients with atrial fibrillation around the world.



Kozieł, Monika ORCID: 0000-0003-0384-1975, Teutsch, Christine ORCID: 0000-0002-8494-2876, Bayer, Valentina, Lu, Shihai, Gurusamy, Venkatesh K, Halperin, Jonathan L, Rothman, Kenneth J, Diener, Hans-Christoph, Ma, Chang-Sheng, Huisman, Menno V
et al (show 2 more authors) (2021) Changes in anticoagulant prescription patterns over time for patients with atrial fibrillation around the world. Journal of arrhythmia, 37 (4). 990 - 1006.

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Abstract

<h4>Background</h4>Prescribing patterns for stroke prevention in atrial fibrillation (AF) patients evolved with approval of non-Vitamin K antagonist oral anticoagulants (NOACs) over time.<h4>Objectives</h4>To assess changes in anticoagulant prescription patterns in various geographical regions upon first approval of a NOAC and to analyze the evolution of oral anticoagulants (OACs) use over time in relation to CHA<sub>2</sub>DS<sub>2</sub>-VASc and HAS-BLED risk profiles.<h4>Methods</h4>Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation <b>(</b>GLORIA-AF) Phases II and III reported data on antithrombotic therapy for patients with newly diagnosed AF and ≥1 stroke risk factor. We focused on sites enrolling patients in both phases and reported treatment patterns for the first 4 years after initial NOAC approval.<h4>Results</h4>From GLORIA-AF Phases II and III, 27 432 patients were eligible for this analysis. When contrasting the first year with the fourth year of enrolment, the proportion of NOAC prescriptions increased in Asia from 29.2% to 60.8%, in Europe from 53.4% to 75.8%, in North America from 49.0% to 73.9% and in Latin America from 55.7% to 71.1%. The proportion of Vitamin K antagonists (VKAs) use decreased across all regions over time, in Asia from 26.0% to 9.8%, in Europe from 35.5% to 16.8%, in North America from 28.9% to 12.1%, and in Latin America from 32.4% to 17.8%. In the multivariable analysis, factors associated with NOAC prescription were as follows: enrolment year, type of site, region, stroke and bleeding risk scores, and type and categorization of AF.<h4>Conclusions</h4>During 4 years after the approval of the first NOAC, NOAC use increased, while VKA use decreased, across all regions.

Item Type: Article
Uncontrolled Keywords: GLORIA‐AF Investigators
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Dec 2021 16:23
Last Modified: 26 Aug 2022 21:10
DOI: 10.1002/joa3.12588
URI: https://livrepository.liverpool.ac.uk/id/eprint/3145213