Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naïve atrial fibrillation patients: Danish nationwide descriptive data 2011–2013
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Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naïve atrial fibrillation patients : Danish nationwide descriptive data 2011–2013. / Olesen, Jonas Bjerring; Sørensen, Rikke; Hansen, Morten Lock; Lamberts, Morten; Weeke, Peter; Mikkelsen, Anders P; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian; Fosbøl, Emil L.
I: Europace, Bind 17, Nr. 2, 02.2015, s. 187-193.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naïve atrial fibrillation patients
T2 - Danish nationwide descriptive data 2011–2013
AU - Olesen, Jonas Bjerring
AU - Sørensen, Rikke
AU - Hansen, Morten Lock
AU - Lamberts, Morten
AU - Weeke, Peter
AU - Mikkelsen, Anders P
AU - Køber, Lars
AU - Gislason, Gunnar H
AU - Torp-Pedersen, Christian
AU - Fosbøl, Emil L
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.
PY - 2015/2
Y1 - 2015/2
N2 - AIMS: Non-vitamin K antagonist oral anticoagulation (NOAC) agents have been approved for stroke prophylaxis in atrial fibrillation (AF). We investigated 'real-world' information on how these drugs are being adopted.METHODS AND RESULTS: Using Danish nationwide administrative registers, we identified all oral anticoagulation-naïve AF patients initiating oral anticoagulation from 22 August 2011 through 31 October 2013. Using logistic regression analysis, baseline characteristics and temporal utilization trends were compared between initiators of warfarin vs. one of the N OACs: dabigatran, rivaroxaban, or apixaban. We identified 18 611 oral anticoagulation-naïve AF patients of which 9902 (53%) initiated warfarin treatment, 7128 (38%) dabigatran, 1303 (7%) rivaroxaban, and 278 (1%) apixaban. Overall, 40% of newly initiated patients were started on dabigatran within the first 4 months of when the drug came on market. By October, 2013, 40% were being started on warfarin and dabigatran, respectively, and another 20% were started on either rivaroxaban or apixaban. Rivaroxaban and apixaban users generally had a higher predicted risk of stroke and bleeding compared with warfarin and dabigatran users. Older age, female gender, and prior stroke were some of the factors associated with NOAC use vs. warfarin, whereas chronic kidney disease, myocardial infarction, and heart failure showed the opposite association.CONCLUSION: Among oral anticoagulation-naïve AF patients initiated on oral anticoagulation in Denmark, warfarin initiation has declined since the introduction of dabigatran in August 2011. Dabigatran is the most frequently used alternative option to warfarin; however, use of rivaroxaban and apixaban is increasing. Patients initiated with rivaroxaban or apixaban in general have a higher predicted stroke and bleeding risks compared with warfarin or dabigatran initiators.
AB - AIMS: Non-vitamin K antagonist oral anticoagulation (NOAC) agents have been approved for stroke prophylaxis in atrial fibrillation (AF). We investigated 'real-world' information on how these drugs are being adopted.METHODS AND RESULTS: Using Danish nationwide administrative registers, we identified all oral anticoagulation-naïve AF patients initiating oral anticoagulation from 22 August 2011 through 31 October 2013. Using logistic regression analysis, baseline characteristics and temporal utilization trends were compared between initiators of warfarin vs. one of the N OACs: dabigatran, rivaroxaban, or apixaban. We identified 18 611 oral anticoagulation-naïve AF patients of which 9902 (53%) initiated warfarin treatment, 7128 (38%) dabigatran, 1303 (7%) rivaroxaban, and 278 (1%) apixaban. Overall, 40% of newly initiated patients were started on dabigatran within the first 4 months of when the drug came on market. By October, 2013, 40% were being started on warfarin and dabigatran, respectively, and another 20% were started on either rivaroxaban or apixaban. Rivaroxaban and apixaban users generally had a higher predicted risk of stroke and bleeding compared with warfarin and dabigatran users. Older age, female gender, and prior stroke were some of the factors associated with NOAC use vs. warfarin, whereas chronic kidney disease, myocardial infarction, and heart failure showed the opposite association.CONCLUSION: Among oral anticoagulation-naïve AF patients initiated on oral anticoagulation in Denmark, warfarin initiation has declined since the introduction of dabigatran in August 2011. Dabigatran is the most frequently used alternative option to warfarin; however, use of rivaroxaban and apixaban is increasing. Patients initiated with rivaroxaban or apixaban in general have a higher predicted stroke and bleeding risks compared with warfarin or dabigatran initiators.
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Anticoagulants
KW - Atrial Fibrillation
KW - Benzimidazoles
KW - Comorbidity
KW - Dabigatran
KW - Denmark
KW - Female
KW - Heart Failure
KW - Humans
KW - Male
KW - Middle Aged
KW - Morpholines
KW - Myocardial Infarction
KW - Myocardial Ischemia
KW - Practice Patterns, Physicians'
KW - Pyrazoles
KW - Pyridones
KW - Registries
KW - Renal Insufficiency, Chronic
KW - Rivaroxaban
KW - Sex Factors
KW - Stroke
KW - Thiophenes
KW - Warfarin
KW - beta-Alanine
U2 - 10.1093/europace/euu225
DO - 10.1093/europace/euu225
M3 - Journal article
C2 - 25236181
VL - 17
SP - 187
EP - 193
JO - Europace
JF - Europace
SN - 1099-5129
IS - 2
ER -
ID: 152271938