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Oral anticoagulants usage in Japanese patients aged 18–74 years with non-valvular atrial fibrillation: a retrospective analysis based on insurance claims data
- Source :
- Family Practice. 36:685-692
- Publication Year :
- 2019
- Publisher :
- Oxford University Press (OUP), 2019.
-
Abstract
- Background Oral anticoagulants use has increased rapidly, internationally. Here we look at risks and benefits, based on Japanese data, of therapy with low risk non-valvular atrial fibrillation patients. Objectives Using a health insurance claims data set we assessed: (i) oral anticoagulants usage in Japan, and (ii) efficacy and safety of dabigatran compared with warfarin, in Japanese patients with non-valvular atrial fibrillation, aged 18–74 years. Methods We identified 4380 non-valvular atrial fibrillation patients treated with anticoagulants between 1 January 2005, and 28 February 2014, and estimated the adjusted hazard ratio for stroke or systemic embolism, and any hemorrhagic event (Cox proportional hazards regression model with stabilized inverse probability treatment weighting). Results The data included 101 989 anticoagulant prescriptions for 4380 patients, of which direct oral anticoagulants increased to 40.0% of the total by the end of the study. After applying exclusion criteria, 1536 new non-valvular atrial fibrillation patients were identified, including 1071 treated with warfarin and 465 with dabigatran. Mean ages were 56.11 ± 9.70 years for warfarin, and 55.80 ± 9.65 years for dabigatran. The adjusted hazard ratio (95% confidence interval), comparing dabigatran with warfarin, was 0.48 (0.25–0.91) for stroke or systemic embolism, and 0.91 (0.60–1.39) for any hemorrhage including intracranial and gastrointestinal. Conclusions Number of patients prescribed direct oral anticoagulants steadily increased, and incidence of all-cause bleeding related to dabigatran was similar to warfarin, in our study population of younger non-valvular atrial fibrillation patients. Dabigatran, compared with warfarin, generally reduced risk of all-cause stroke and systemic embolism.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
medicine.drug_class
Embolism
Administration, Oral
Hemorrhage
030204 cardiovascular system & hematology
Drug Prescriptions
Dabigatran
Young Adult
03 medical and health sciences
0302 clinical medicine
Japan
Internal medicine
Atrial Fibrillation
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Stroke
Aged
Proportional Hazards Models
Retrospective Studies
business.industry
Incidence
Hazard ratio
Anticoagulant
Warfarin
Anticoagulants
Atrial fibrillation
Middle Aged
medicine.disease
Confidence interval
Logistic Models
Female
Family Practice
business
medicine.drug
Subjects
Details
- ISSN :
- 14602229
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Family Practice
- Accession number :
- edsair.doi.dedup.....9cb3e77ce316e1547f47be472503eab7