Key result
NOAC era linked to a ~38% increase in discharge anticoagulation for hospitalized AF.
Why the study?
Has the prescription rate of anticoagulation therapy in hospitalized non-valvular AF patients increased in the NOACs era compared to the pre-NOACs era?
Observational (n=335)
No
Has the prescription rate of anticoagulation therapy in hospitalized non-valvular AF patients increased in the NOACs era compared to the pre-NOACs era?
Absolute Event Rate: 76% vs 55%
The introduction of NOACs has significantly increased the rate of anticoagulation prescription among hospitalized patients with non-valvular atrial fibrillation.
Supports increased anticoagulation uptake with NOACs in AF inpatients; leaves open effects on outcomes and generalizability.
BACKGROUND: The treatment of atrial fibrillation (AF) includes anticoagulation (AC) therapy to prevent systemic emboli. Until recently, warfarin was the main AC agent, while in recent years, the new oral anticoagulants (NOACs) are increasingly being used. AIM: The aim of our study was to characterize the AC treatment policy of AF patients at the department of medicine in the NOACs era. METHODS AND DESIGN: An observational study of consecutive hospitalized patients with non-valvular AF for a period of 3 months in Beilinson hospital (January to March 2017). Demographic characteristics, clinical data and AC therapeutic approach were compared to those from the pre-NOACs era, based on a previous study. RESULTS: A total of 335 patients were hospitalized with either new (21%) or prior (79%) non-valvular AF. An increase in AC therapy among patients with prior and new AF was observed compared to the pre-NOACs era (76% vs. 59%; P < 0.001 and 68% vs. 49%; P < 0.001, respectively). Totally, 76% of all patients were discharged with AC therapy compared to 55% in the pre-NOACs era. As in the pre-NOACs era, prior AC therapy was the main predictor for the prescription of AC therapy during hospitalization and discharge (OR = 13, 95% CI; 7-25, P = 0.0001). CONCLUSION: There is a significant increase in the AC therapy prescription, mainly NOACs, in hospitalized non-valvular AF patients. This increase could be explained by the difficulties in warfarin treatment and the benefits of NOACs. Nevertheless, a large observational study is required to prove these findings.
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Atamna et al. (2018) conducted an observational in Non-valvular atrial fibrillation (n=335). Anticoagulation therapy in the NOACs era vs. Anticoagulation therapy in the pre-NOACs era was evaluated on Anticoagulation therapy prescription at discharge. Anticoagulation therapy prescription at discharge for hospitalized non-valvular atrial fibrillation patients increased significantly in the NOACs era compared to the pre-NOACs era (76% vs. 55%).
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