Anticoagulation in Patients with Atrial Fibrillation: We Could Be Doing Better

Four years after the introduction of direct oral anticoagulants, the overall use of anticoagulation increased only modestly.

Since the introduction of direct oral anticoagulants (DOACs), which require less intense monitoring than vitamin K antagonists (VKAs), it's been anticipated that more patients with atrial fibrillation (AF) would be anticoagulated. Researchers used data from the National Cardiovascular Data Registry to assess the effect of DOAC availability on overall oral anticoagulation rates for nonvalvular AF from April 2008 through September 2014. More than 600,000 patients were included in the primary analysis.

OAC use increased from 52% to 61% over the study period. Warfarin use decreased from 52% to 35%, and DOAC use increased from 0% to 26% (dabigatran, 7%; rivaroxaban, 12%; apixaban, 6%). In multivariate models, stroke risk factors, male sex, dyslip…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Anticoagulation in Patients with Atrial Fibrillation: We Could Be Doing Better

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Reviewing Author