1. [Factors Associated with Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients with Non-valvular Atrial Fibrillation].
- Author
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Saliba L, Mondoly P, Duparc A, Bura-Rivière A, Maury P, Calmels V, Sallerin B, Pathak A, Montastruc JL, and Bagheri H
- Subjects
- Administration, Oral, Aged, Aged, 80 and over, Anticoagulants administration & dosage, Anticoagulants adverse effects, Anticoagulants classification, Antithrombins administration & dosage, Antithrombins adverse effects, Comorbidity, Dabigatran administration & dosage, Dabigatran adverse effects, Dabigatran therapeutic use, Drug Substitution, Factor Xa Inhibitors administration & dosage, Factor Xa Inhibitors adverse effects, Female, Hemorrhage chemically induced, Hemorrhage epidemiology, Humans, Intracranial Embolism epidemiology, Intracranial Embolism etiology, Male, Middle Aged, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors adverse effects, Platelet Aggregation Inhibitors therapeutic use, Practice Patterns, Physicians', Prospective Studies, Pyrazoles administration & dosage, Pyrazoles adverse effects, Pyrazoles therapeutic use, Pyridones administration & dosage, Pyridones adverse effects, Pyridones therapeutic use, Rivaroxaban administration & dosage, Rivaroxaban adverse effects, Rivaroxaban therapeutic use, Thrombophilia etiology, Warfarin administration & dosage, Warfarin adverse effects, Warfarin therapeutic use, Anticoagulants therapeutic use, Antithrombins therapeutic use, Atrial Fibrillation complications, Factor Xa Inhibitors therapeutic use, Intracranial Embolism prevention & control, Thrombophilia drug therapy, Vitamin K antagonists & inhibitors
- Abstract
Objective: Describing the factors associated with direct oral anticoagulants (DOA) prescription in patients with atrial fibrillation (AF)., Method: This study was performed in Toulouse on a cohort of patients received in rhythmology consultation, treated with vitamin K antagonists (VKA) or DOA for AF. A multivariate model was performed using logistic regression to describe the factors associated with DOA prescription and secondly, those associated with discontinuation of the anticoagulant., Results: Among the 140 patients included, 96 (66%) were treated with VKA and 48 (34%) with DOA. Recent AF diagnosis (OR 7.52, 95% CI [2.41;23.29], p = 0.001), previous exposure to VKA (OR 17.11, 95% CI [4.48;60.91], p<0.001), and no current exposure to anti-platelet agents (APA) (OR 7.69, 95% CI [1.22; 50.00], p = 0.030) were associated to DOA prescription. Discontinuation of the anticoagulant (n=24) was associated to DOA intake (OR 2.71, 95% CI [1.21; 6.08], p = 0.016)., Discussion: DOA are less prescribed than VKA in patients treated with APA. DOA switch to VKA was not systematic in patients diagnosed for a long time. However, international normalized ratio (INR) values were stable in most of patients treated with VKA at the switching to DOA. A more powerful study would confirm the factors associated with DOA prescription., (© 2015 Société Française de Pharmacologie et de Thérapeutique.)
- Published
- 2015
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