Author + information
- Nilay Shah,
- Kensey Gosch,
- Paul Chan,
- Lucas Marzec and
- Henry Ting
The use of novel oral anticoagulants (NOACs) such as direct thrombin inhibitors and direct activated Factor X inhibitors in routine clinical practice is not well described. We undertook this study to characterize the adoption and patterns of use of NOACs in a sample of outpatient cardiology practices.
Using data from July 2009 through June 2012 within the NCDR PINNACLE registry, we examined the rate and type of anticoagulant used for patients with non-valvular atrial fibrillation and a CHADS2 score >2. Hierarchical logistic regression analyses then examined temporal trends in the use of any anticoagulant and for warfarin and NOACs separately
Overall rates of anticoagulation and use of warfarin and NOACs are presented in the table. In the multivariable models, we did not observe a significant trend in rates of anticoagulation (p=0.43). However, there was a statistically significant trend in the increasing use of NOACs and decreasing use of warfarin (p<0.001). Multivariable models showed that increasing male gender and prior stroke were associated with higher odds of receiving NOACs. However, increasing age, higher CHADS2 score and dual antiplatelet therapy were associated with lower likelihood of receiving NOACs.
|Q3 ′09||Q4 ′09||Q1 ′10||Q2 ′10||Q3 ′10||Q4 ′10||Q1 ′11||Q2 ′11||Q3 ′11||Q4 ′11||Q1 ′12||Q2 ′12|
Despite increasing adoption of NOACs into clinical practice, the overall rate of anticoagulant treatment in high risk patients with non-valvular atrial fibrillation has not improved.
Saturday, March 29, 2014, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias and Clinical EP: State of the Art Anticoagulation for Atrial Fibrillation
Abstract Category: 4. Arrhythmias and Clinical EP: AF/SVT
Presentation Number: 1109-122
- 2014 American College of Cardiology Foundation