Factors influencing adherence to non-vitamin K antagonist oral anticoagulants in the early period after atrial fibrillation catheter ablation in China

Hu, Zhicheng; Liu, Shangyu; Wu, Lingmin; Shen, Lishui; Liu, Limin; Li, Guoliang; Zheng, Lihui; Yao, Yan

doi:10.1097/cm9.0000000000001000

Cited by 1 publication

(2 citation statements)

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“…The independent factors that were shown by this study to be associated with higher rates of OAC utilization are not different from those reported by other investigators [ 6 , 8 – 10 , 43 , 44 ]. Patients who had or at higher risk of stroke or systemic embolization due to a high CHA 2 DS 2 -VASc score were more likely to be prescribed with DOACs than those who did not have these features.…”

Section: Discussioncontrasting

confidence: 77%

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Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

Hammoudeh

Khader

Kadri

et al. 2021

International Journal of Vascular Medicine

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Background. There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the utilization of OACs, including vitamin K antagonists (VKAs) and direct OACs (DOACs), in patients with valvular AF (VAF) and nonvalvular AF (NVAF) according to the 2019 focused update of the 2014 AHA/ACC/HRS guidelines. Methods. Consecutive patients with AF were enrolled in 29 hospitals and outpatient clinics. The use of OACs was evaluated in patients with VAF and NVAF according to the prespecified guideline. Results. Of 2000 patients, 177 (8.9%) had VAF and 1823 (91.1%) had NVAF. A VKA was prescribed for 88.1% of the VAF group. In the NVAF group, 1468 (80.5%) of patients had a high CHA2DS2-VASc score, i.e., a score of ≥3 in women and ≥2 in men; 202 (11.1%) patients had an intermediate CHA2DS2-VASc score, i.e., a score of 2 in women and 1 in men; and 153 (8.4%) patients had a low CHA2DS2-VASc score, i.e., a score of 1 in women and 0 in men. Of patients with a high CHA2DS2-VASc score, 1204 (82.0%) received OACs, including DOACs for 784 (53.4%) and VKA for 420 (28.6%) patients. Among patients with an intermediate score, OACs were prescribed for 148 (73.3%) patients, including 107 (53.0%) who received DOACs and 41 (20.3%) patients who received VKA. In patients with a low score, OACs were omitted in 94 (61.4%) patients and prescribed for 59 (38.6%) patients. Multivariate analysis showed that age between 50 and 70 years, CHA2DS2-VASc score of ≥2, a diagnosis of stroke or systemic embolization, and nonparoxysmal AF were significantly associated with increased odds of OAC prescription. Conclusions. The current status of the utilization of OACs in Middle Eastern AF patients appears to be promising and is consistent with the 2019 focused update of the 2014 AHA/ACC/HRS guideline. This trial is registered with NCT03917992.

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Section: Discussioncontrasting

confidence: 77%

“…Other factors reported by other investigators to be associated with higher odds of utilizing OACs include duration of AF > 5 years, higher education levels, treatment by a cardiologist, and using a pill sorting box and calendar. Frailty and self-paying, on the other hand, were associated with lower odds of prescribing OACs [ 43 – 45 ].…”

Section: Discussionmentioning

confidence: 99%