Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation: experience at a Japanese single institution
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  • 作者:Manaka Tagaya ; Daiji Yoshikawa ; Yoshinori Sugishita ; Fumi Yamauchi…
  • 刊名:Heart and Vessels
  • 出版年:2016
  • 出版时间:June 2016
  • 年:2016
  • 卷:31
  • 期:6
  • 页码:957-962
  • 全文大小:527 KB
  • 刊物类别:Medicine
  • 刊物主题:Medicine & Public Health
    Cardiology
    Cardiac Surgery
    Vascular Surgery
    Biomedical Engineering
    Interventional Radiology
    Ultrasound
  • 出版者:Springer Japan
  • ISSN:1615-2573
  • 卷排序:31
文摘
New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 %) patients were treated with NOACs and 109 (60 %) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.KeywordsAnticoagulantsArrhythmiaAtrial fibrillationDrugsWarfarin

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