Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2020.61.440
Patterns of anticoagulation therapy in atrial fibrillation: results from a large real-life single-center registry
Ivana Jurin
; Department for Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Marko Lucijanić
; Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
Zrinka Šakić
; Health Center Zagreb East, Zagreb, Croatia
Vanja Hulak Karlak
Armin Atić
; Emergency Department, University Hospital Dubrava, Zagreb, Croatia
Ana Magličić
; Department of Oncology and Radiotherapy, University Hospital Center Zagreb, Zagreb, Croatia
Boris Starčević
; Department for Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Irzal Hadžibegović
; Department for Cardiovascular Diseases, University Hospital Dubrava, Zagreb, Croatia
Sažetak
Aim To investigate the differences in the characteristics
and clinical outcomes of recently diagnosed patients with
atrial fibrillation (AF) receiving different types of anticoagulants in a real-life setting.
Methods We retrospectively analyzed the charts of 1000
consecutive patients with non-valvular AF diagnosed at
and referred for hospitalazation to our institution from
2013 to 2018.
Results Over the observed period, the frequency of direct
oral anticoagulation (DOAC) therapy use significantly increased (P=0.002). Patients receiving warfarin had more
unfavorable thromboembolic and bleeding risk factors
than patients receiving DOAC. Predetermined stroke and
major bleeding risks were similarly distributed among the
dabigatran, rivaroxaban, and apixaban groups. Patients receiving warfarin had shorter time-to-major bleeding (TTB),
time to thrombosis (TTT), and overall survival (OS) than patients receiving DOACs. After adjustment for factors unbalanced at baseline, the warfarin group showed significantly
shorter OS (hazard ratio 2.27, 95% confidence interval 1.44-
3.57, P<0.001], while TTB and TTT did not significantly differ between the groups. Only 37% of patients on warfarin
had optimal dosing control, and they did not differ significantly in TTB, TTT, and OS from patients on DOACs.
Conclusion Warfarin and DOACs are administered to different target populations, possibly due to socio-economic
reasons. Patients receiving warfarin rarely obtain optimal
dosing control, and experience significantly shorter survival compared with patients receiving DOACs
Ključne riječi
Hrčak ID:
277993
URI
Datum izdavanja:
23.10.2020.
Posjeta: 349 *