PMID- 35127843
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220501
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 8
DP  - 2021
TI  - Real-World Data of Anticoagulant Treatment in Non-valvular Atrial Fibrillation.
PG  - 733300
LID - 10.3389/fcvm.2021.733300 [doi]
LID - 733300
AB  - AIMS: To assess the impact of anticoagulant treatment on risk for stroke and 
      all-cause mortality of patients with atrial fibrillation using real-world data 
      (RWD). METHODS: Patients with prevalent or incident atrial fibrillation were 
      selected throughout a study period of 5 years. Stroke, transitory ischemic 
      attack, hemorrhagic stroke, and all-cause mortality were identified in the claims 
      of the electronic health records (EHRs). Subjects were classified according to 
      the anticoagulant treatment in four groups: untreated, vitamin K antagonists 
      (VKAs), New Oral Anticoagulants (NOACs), and antiplatelet (AP). Risk of events 
      and protection with anticoagulant therapy were calculated by Cox proportional 
      hazard models adjusted by potential confounders. RESULTS: From a total population 
      of 3,799,884 patients older than 18,123,227 patients with incident or prevalent 
      atrial fibrillation (AF) were identified (mean age 75.2 +/- 11.5 years old; 51.9% 
      women). In a follow-up average of 3.2 years, 17,113 patients suffered from an 
      ischemic stroke and transitory ischemic attack (TIA), 780 hemorrhagic stroke, and 
      42,558 all-cause death (incidence of 46, 8, 2, and 120 per 1,000 patients/year, 
      respectively). Among CHA2DS2, VASc Score equal or >2, 11.7% of patients did not 
      receive any anticoagulant therapy, and a large proportion of patients, 47%, 
      shifted from one treatment to another. Although all kinds of anticoagulant 
      treatments were significantly protective against the events and mortality, NOAC 
      treatment offered significantly better protection compared to the other groups. 
      CONCLUSION: In the real world, the use of anticoagulant treatments is far from 
      guidelines recommendations and is characterized by variability in their use. 
      NOACs offered better protection compared with VKAs.
CI  - Copyright (c) 2022 Calderon, Martinez, Diaz, Fernandez, Sauri, Uso, Trillo, Vela, 
      Bea, Redon and Forner.
FAU - Calderon, Jose Miguel
AU  - Calderon JM
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
FAU - Martinez, Fernando
AU  - Martinez F
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
AD  - Internal Medicine Hospital Clinico de Valencia, Valencia, Spain.
FAU - Diaz, Javier
AU  - Diaz J
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
FAU - Fernandez, Antonio
AU  - Fernandez A
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
FAU - Sauri, Inmaculada
AU  - Sauri I
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
FAU - Uso, Ruth
AU  - Uso R
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
FAU - Trillo, Jose Luis
AU  - Trillo JL
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
FAU - Vela, Sara
AU  - Vela S
AD  - Internal Medicine Hospital Clinico de Valencia, Valencia, Spain.
FAU - Bea, Carlos
AU  - Bea C
AD  - Internal Medicine Hospital Clinico de Valencia, Valencia, Spain.
FAU - Redon, Josep
AU  - Redon J
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
AD  - Internal Medicine Hospital Clinico de Valencia, Valencia, Spain.
AD  - CIBERObn Carlos III Institute, Madrid, Spain.
FAU - Forner, Maria Jose
AU  - Forner MJ
AD  - Cardiovascular and Renal Research Group, INCLIVA Research Institute, University 
      of Valencia, Valencia, Spain.
AD  - Internal Medicine Hospital Clinico de Valencia, Valencia, Spain.
LA  - eng
PT  - Journal Article
DEP - 20220121
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC8814520
OTO - NOTNLM
OT  - NOACs
OT  - VKA
OT  - anticoagulant therapy
OT  - antiplatelet
OT  - atrial fibrillation
OT  - mortality
OT  - stroke
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/02/08 06:00
MHDA- 2022/02/08 06:01
PMCR- 2021/01/01
CRDT- 2022/02/07 05:35
PHST- 2021/07/06 00:00 [received]
PHST- 2021/12/02 00:00 [accepted]
PHST- 2022/02/07 05:35 [entrez]
PHST- 2022/02/08 06:00 [pubmed]
PHST- 2022/02/08 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2021.733300 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2022 Jan 21;8:733300. doi: 10.3389/fcvm.2021.733300. 
      eCollection 2021.