Why the study?
Does vitamin K antagonist therapy achieve adequate anticoagulation and treatment satisfaction in Korean patients with non-valvular atrial fibrillation?
Does vitamin K antagonist therapy achieve adequate anticoagulation and treatment satisfaction in Korean patients with non-valvular atrial fibrillation?
In Korean patients with non-valvular atrial fibrillation, vitamin K antagonist therapy is associated with poor INR control (73% with TTR < 60%) and low treatment satisfaction, highlighting the limitations of VKA in real-world practice.
Highlights challenges with VKA monitoring in Korean NVAF; leaves open whether DOACs improve real-world outcomes.
BACKGROUND: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. METHODS: ≥ 1 and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. RESULTS: -VASc ≥ 2. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. CONCLUSION: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.
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Oh et al. (2018) studied this question.
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