TY - JOUR
T1 - Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?-Results of the Polish Atrial Fibrillation (POL-AF) Registry
AU - Szyszkowska, A.
AU - Kuzma, L.
AU - Wozakowska-Kaplon, B.
AU - Gorczyca-Glowacka, I.
AU - Jelonek, O.
AU - Uzieblo-Zyczkowska, B.
AU - Krzesinski, P.
AU - Wojcik, M.
AU - Blaszczyk, R.
AU - Gawalko, M.
AU - Kaplon-Cieslicka, A.
AU - Tokarek, T.
AU - Rajtar-Salwa, R.
AU - Bil, J.
AU - Wojewodzki, M.
AU - Szpotowicz, A.
AU - Krzciuk, M.
AU - Bednarski, J.
AU - Bakula, E.
AU - Welnicki, M.
AU - Mamcarz, A.
AU - Tomaszuk-Kazberuk, A.
N1 - 2022-11-03 FHML (ML) Handmatige RS-lijn i.v.m. uitstel sync. Info uit lijst CN.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA(2)DS(2)-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use-out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
AB - Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA(2)DS(2)-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use-out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
KW - atrial fibrillation
KW - ischemic stroke
KW - anticoagulation
KW - reduced dose
KW - ORAL ANTICOAGULANTS
KW - ANTITHROMBOTIC THERAPY
KW - PREDICTING STROKE
KW - WARFARIN
KW - RISK
KW - PREVENTION
KW - SAFETY
KW - METAANALYSIS
KW - RIVAROXABAN
KW - EFFICACY
U2 - 10.3390/ijerph191911939
DO - 10.3390/ijerph191911939
M3 - Article
C2 - 36231257
SN - 1660-4601
VL - 19
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 19
M1 - 11939
ER -