Author + information
- Naja Emborg Vinding,
- Anders Nissen Bonde,
- Rasmus Rørth,
- Morten Lamberts,
- Jonas Bjerring Olesen,
- Gunnar Gislason,
- Christian Torp-Pedersen,
- Lars Køber and
- Emil Loldrup Fosbøl
Background: Patients with non-valvular atrial fibrillation (NVAF) receiving vitamin K antagonists (VKA) with time in therapeutic range (TTR) <70 % are recommended to shift to non-vitamin K antagonist oral anticoagulants (NOAC). However, it is unknown if this is practise in real-world patients.
Method: NVAF patients receiving VKA (Jan 1, 2011 to Dec 31, 2012) were identified in nationwide administrative registries. TTR was calculated by the Rosendaal method by a minimum of three international normalized ratio (INR) values. In this study we compared TTR values of patients with NVAF receiving VKA treatment (non-shifters) to patients shifting from VKA to dabigatran (shifters).
Results: A total of 5511 patients with NVAF receiving VKA were included; of these, 4872 patients continued on VKA (male 58.6%, median age 77 [IQR 69-84]) and 639 patients shifted to dabigatran (male 53.2%, median age 76 [IQR 68-83]). The proportion of patients with chronic kidney disease were significantly higher in non-shifters compared with shifters (7% vs. 4 %, p = 0.003) whereas alcohol abuse was lower (6% vs. 8%, p = 0.049). No significant differences in CHA2DS2-VASc and HAS-BLED scores were seen between the two groups. Among non-shifters 47% had a TTR<70 %, whereas this was 71% among shifters (Figure 1).
Conclusions: Most patients who shifted from VKA to dabigatran had a TTR < 70%. However, the vast majority of patients with TTR <70% continued VKA treatment opposite clinical guideline recommendations.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Specific Situations and Newer Outcome Measures
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1190-108
- 2017 American College of Cardiology Foundation