Key result
NOACs show a low 1-year rate of MACCE at ~2.3% in unselected AF patients.
Why the study?
The management of patients with atrial fibrillation rapidly changed with increasing use of NOACs and evolving rhythm control therapy at the time of NOAC introduction.
Observational (n=3,783)
Yes
Answers are grounded in this paper and cite their sources.
In a contemporary European cohort of unselected AF patients treated with NOACs, adverse event rates were low despite high thromboembolic risk.
The management of patients with atrial fibrillation (AF) has rapidly changed with increasing use of non-vitamin K antagonist oral anticoagulants (NOACs) and changes in the use of rhythm control therapy. The prevention of thromboembolic events European Registry in Atrial Fibrillation Prolongation Registry (PREFER Prolongation) enrolled consecutive patients with AF on NOACs between 2014 and 2016 in a multicentre, prospective, observational study with one-year follow-up, focusing on the time of introduction of NOACs. Overall, 3783 patients were enrolled, with follow-up information available in 3223 (85%). Mean age was 72.2 ± 9.4 years, 40% were women, mean CHA2DS2VASc score was 3.4 ± 1.6, and 2587 (88.6%) had a CHA2DS2VASc score ≥ 2. Rivaroxaban was used in half of patients, and dabigatran and apixaban were used in about a quarter of patients each; edoxaban was not available for use in Europe at the time. Major cardiovascular event rate was low: serious events occurred in 74 patients (84 events, 2%), including 24 strokes (1%), 62 major bleeds (2%), of which 30 were life-threatening (1%) and 3 intracranial (0.1%), and 28 acute coronary syndromes (1%). Mortality was 2%. Antiarrhythmic drugs were used in about 50% of patients, catheter ablation in 5%. Adverse events were low in this contemporary European cohort of unselected AF patients treated with NOACs already at the time of their first introduction, despite high thromboembolic risk.
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Renda et al. (2020) conducted an observational in Atrial fibrillation (n=3,783). Non-vitamin K antagonist oral anticoagulants (NOACs) was evaluated on Major adverse cardiac and cerebrovascular events (MACCE). In a European registry of unselected atrial fibrillation patients treated with NOACs, the 1-year rate of major adverse cardiac and cerebrovascular events was low at 2.3%, with major bleeding at 2.0%.
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