PMID- 37781690
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231004
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 14
DP  - 2023
TI  - Effectiveness and safety of oral anticoagulants for non-valvular atrial 
      fibrillation: a population-based cohort study in primary healthcare in Catalonia.
PG  - 1237454
LID - 10.3389/fphar.2023.1237454 [doi]
LID - 1237454
AB  - Objectives: Our objective was to analyse effectiveness and safety of oral 
      anticoagulants (OAC) for stroke prevention in non-valvular atrial fibrillation. 
      Material and methods: Population-based cohort study including adults initiating 
      oral anticoagulants, either direct oral anticoagulants (DOAC) or vitamin K 
      antagonists (VKA), during 2011-2020. Data source: SIDIAP, capturing information 
      from the electronic health records of Primary Health Care in Catalonia, Spain. 
      Study outcomes: stroke, cerebral and gastrointestinal (GI) haemorrhage, assessed 
      by patients' subgroups according to different clinical characteristics. Results: 
      We included 90,773 patients. Male sex, older than 75, previous event, peripheral 
      artery disease, deep vein thrombosis, or receiving antiplatelets, antidiabetics 
      or proton pump inhibitors (PPI) was associated with higher stroke risk. For 
      DOAC-treated, treatment switch increased stroke risk, while being adherent had a 
      protective effect. Men, antidiabetic treatment or a previous event increased the 
      risk of cerebral bleeding. Receiving direct oral anticoagulants had a protective 
      effect in comparison to vitamin K antagonists. For DOAC-treated, treatment switch 
      increased, and adherence decreased the bleeding risk. Men, people with chronic 
      kidney disease or a previous event posed an increased risk of gastrointestinal 
      bleeding, whereas receiving PPI had a protective effect. For DOAC-treated, switch 
      was associated with a higher bleeding risk. Conclusion: Being men, a previous 
      event and DOAC-switch posed a higher risk for all study outcomes. direct oral 
      anticoagulants had a protective effect against cerebral bleeding in comparison to 
      vitamin K antagonists. Adherence to direct oral anticoagulants resulted in lower 
      risk of stroke and cerebral bleeding. We found no differences in the risk of 
      stroke and gastrointestinal bleeding when we compared direct oral anticoagulants 
      vs. vitamin K antagonists.
CI  - Copyright (c) 2023 Giner-Soriano, Ouchi, Vives, Vilaplana-Carnerero, Molina, 
      Vallano and Morros.
FAU - Giner-Soriano, Maria
AU  - Giner-Soriano M
AD  - Fundacio Institut Universitari per a la Recerca a l'Atencio Primaria de Salut 
      Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Ouchi, Dan
AU  - Ouchi D
AD  - Fundacio Institut Universitari per a la Recerca a l'Atencio Primaria de Salut 
      Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Barcelona, Spain.
FAU - Vives, Roser
AU  - Vives R
AD  - Department of Pharmacology, Therapeutics and Toxicology, Universitat Autonoma de 
      Barcelona, Barcelona, Spain.
AD  - Medicines Department, Catalan Healthcare Service, Barcelona, Spain.
FAU - Vilaplana-Carnerero, Carles
AU  - Vilaplana-Carnerero C
AD  - Fundacio Institut Universitari per a la Recerca a l'Atencio Primaria de Salut 
      Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
AD  - Universitat Autonoma de Barcelona, Barcelona, Spain.
AD  - Plataforma SCReN, UIC IDIAPJGol, Barcelona, Spain.
AD  - Department of Medicine, University of Barcelona, Barcelona, Spain.
FAU - Molina, Andrea
AU  - Molina A
AD  - Department of Pharmacology, Therapeutics and Toxicology, Universitat Autonoma de 
      Barcelona, Barcelona, Spain.
AD  - Medicines Department, Catalan Healthcare Service, Barcelona, Spain.
FAU - Vallano, Antoni
AU  - Vallano A
AD  - Department of Pharmacology, Therapeutics and Toxicology, Universitat Autonoma de 
      Barcelona, Barcelona, Spain.
AD  - Medicines Department, Catalan Healthcare Service, Barcelona, Spain.
AD  - Institut Catala de la Salut, Barcelona, Spain.
FAU - Morros, Rosa
AU  - Morros R
AD  - Fundacio Institut Universitari per a la Recerca a l'Atencio Primaria de Salut 
      Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
AD  - Department of Pharmacology, Therapeutics and Toxicology, Universitat Autonoma de 
      Barcelona, Barcelona, Spain.
AD  - Plataforma SCReN, UIC IDIAPJGol, Barcelona, Spain.
AD  - Institut Catala de la Salut, Barcelona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20230915
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC10540223
OTO - NOTNLM
OT  - adherence
OT  - atrial fibrillation
OT  - effectiveness
OT  - electronic health records
OT  - oral anticoagulants
OT  - primary healthcare
OT  - safety
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- 2023/10/02 06:42
MHDA- 2023/10/02 06:43
PMCR- 2023/09/15
CRDT- 2023/10/02 04:50
PHST- 2023/06/09 00:00 [received]
PHST- 2023/09/05 00:00 [accepted]
PHST- 2023/10/02 06:43 [medline]
PHST- 2023/10/02 06:42 [pubmed]
PHST- 2023/10/02 04:50 [entrez]
PHST- 2023/09/15 00:00 [pmc-release]
AID - 1237454 [pii]
AID - 10.3389/fphar.2023.1237454 [doi]
PST - epublish
SO  - Front Pharmacol. 2023 Sep 15;14:1237454. doi: 10.3389/fphar.2023.1237454. 
      eCollection 2023.