Key result
Acute DVT linked to ~24 percentage point higher DOAC prescription rates than non-valvular AF.
Why the study?
The study was conducted to assess oral anticoagulant preferences in patients diagnosed with acute deep vein thrombosis of the lower limbs or non-valvular atrial fibrillation requiring medium- or long-term anticoagulation.
Does the indication for anticoagulation (DVT vs AF) influence the preference for DOACs vs VKAs in hospitalized patients?
Cohort (n=674)
No
Does the indication for anticoagulation (DVT vs AF) influence the preference for DOACs vs VKAs in hospitalized patients?
Absolute Event Rate: 48.5% vs 24.8%
This real-world study demonstrates a continued reliance on vitamin K antagonists over DOACs for atrial fibrillation patients with comorbidities, likely driven by cost considerations.
(1) Aim: The aim of this study was to assess the preferences of oral anticoagulants (OA) in patients diagnosed with deep vein thrombosis (DVT) of lower limbs or non-valvular atrial fibrillation (AF) requiring anticoagulation for medium/long term. (2) Materials and methods: the study included consecutive patients admitted with a diagnosis of either acute DVT of lower limbs (without signs of pulmonary embolism) or non-valvular AF who required oral anticoagulation, in a time frame of 18 months from January 2017 until June 2018. The following data were recorded: demographic variables, comorbidities (ischemic heart disease, arterial hypertension, heart failure, stroke, peripheral artery disease, diabetes mellitus, obesity), type and dose of OA (acenocoumarol, dabigatran, apixaban, rivaroxaban), complications due to the use of OA. (3) Results: AF patients were older and had considerably more cardiovascular comorbidities than DVT patients. Vitamin K antagonists (VKA) were more likely to be administered in patients with AF, as they had indication for indefinite anticoagulation. VKA were more frequently prescribed in patients with ischemic heart disease, heart failure, and diabetes compared with DVT patients. Moreover, complications related to OA use were more frequent in the VKA group. Almost half of patients with acute DVT (48.5%) were treated with direct OA (DOAC) rather than VKA, and only a quarter of AF patients (24.8%) were treated with DOACs.
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Vesa et al. (2020) conducted a cohort in Acute Deep Vein Thrombosis or Non-Valvular Atrial Fibrillation (n=674). Acute deep vein thrombosis vs. Non-valvular atrial fibrillation was evaluated on Direct oral anticoagulant (DOAC) prescription rate. Patients with acute deep vein thrombosis were more frequently prescribed direct oral anticoagulants (48.5%) compared to patients with non-valvular atrial fibrillation (24.8%).
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