Key result
Direct oral anticoagulants were used in 79.4% and vitamin K antagonists in 15.9% of atrial fibrillation patients, with a high rate of overuse in those with low stroke risk.
Why the study?
There is limited real-world information regarding stroke and systemic embolism prevention strategies and anticoagulant treatment patterns in patients with atrial fibrillation.
What are the real-world anticoagulant treatment patterns and dosing practices in patients with atrial fibrillation?
Observational (n=2,597)
Yes
What are the real-world anticoagulant treatment patterns and dosing practices in patients with atrial fibrillation?
Real-world data highlights high utilization of DOACs for atrial fibrillation but reveals significant gaps in care, including inadequate TTR for VKA users and frequent inappropriate dose reductions for DOACs.
Answers are grounded in this paper and cite their sources.
High DOAC overuse in low-risk AF signals prescribing caution; leaves open how to align real-world patterns with guidelines.
OBJECTIVE: Oral anticoagulant therapy is the cornerstone of atrial fibrillation management to prevent stroke and systemic embolism. However, there is limited real-world information regarding stroke and systemic embolism prevention strategies in patients with atrial fibrillation. The aim of the ROTA study is to obtain the real-world data of anticoagulant treatment patterns in patients with atrial fibrillation. METHODS: The ROTA study is a prospective, multicenter, and observational study that included 2597 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January 2021 and May 2021. RESULTS: The median age of the study population was 72 years (range: 22-98 years) and 57.4% were female. The median CHA2DS2-VASc and HAS-BLED scores were 4 (range: 0-9) and 1 (range: 0-6), respectively. Vitamin K antagonists and direct oral anticoagulants were used in 15.9% and 79.4% of patients, respectively. The mean time in therapeutic range was 52.9% for patients receiving vitamin K antagonists, and 76% of those patients had an inadequate time in therapeutic range with <70%. The most common prescribed direct oral anticoagulants were rivaroxaban (38.1%), apixaban (25.5%), and edoxaban (11.2%). The rate of overuse of vitamin K antagonists and direct oral anticoagulants was high (76.1%) in patients with low stroke risk, and more than one-fourth of patients on direct oral anticoagulant therapy were receiving a reduced dose of direct oral anticoagulants. Among patients who were on direct oral anticoagulant treatment, patients with apixaban treatment were older, had higher CHA2DS2-VASc and HAS-BLED scores, and had lower creatinine clearance than the patients receiving other direct oral anticoagulants. CONCLUSIONS: The ROTA study provides important real-world information about anticoagulant treatment patterns in patients with atrial fibrillation.time in therapeutic range with <70%.
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Umut Kocabaş (2023) conducted an observational in Atrial fibrillation (n=2,597). Oral anticoagulant therapy was evaluated on Anticoagulant treatment patterns. Direct oral anticoagulants were used in 79.4% and vitamin K antagonists in 15.9% of atrial fibrillation patients, with a high rate of overuse in those with low stroke risk.
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