Abstract
Background: We explored patterns of and factors associated with the use of oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF) in contemporary Canadian practice. Methods: Phase 1 of the Stroke Prevention and Rhythm Intervention in Atrial Fibrillation (SPRINT-AF) registry was a cross-sectional retrospective study of patients with nonvalvular AF (NVAF). From December 2012-July 2013, 936 consecutive patients with NVAF were enrolled in SPRINT-AF. Of the 782 patients treated with OAC, the proportion treated with warfarin and a new oral anticoagulant (NOAC) was 53.2% and 46.8%, respectively. The rate of OAC use was 90.9% among patients with a CHADS2 (Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke/Transient Ischemic Attack) score ≥ 2. Results: On multivariable analysis, the 2 strongest factors associated with NOAC use (compared with warfarin use) were an improved side effect profile (as perceived by the patient) and improved efficacy (as perceived by the physician) (odds ratio [OR], 0.10; 95% confidence interval [CI], 0.06-0.17; P < 0.01 and OR, 0.52; 95% CI, 0.36-0.76; P < 0.01, respectively). Lower cost was strongly associated with warfarin use (OR, 5.16; 95% CI, 3.49-7.63; P < 0.01). Conclusions: In this contemporary Canadian AF registry, the rate of guideline-concordant OAC use was high. About half of OAC-treated patients received NOACs. Patient- and physician-driven preferences, such as side effect profile, perceived greater efficacy, and cost, were strong determinants of NOAC use over warfarin use. Introduction: Méthodes: Résultats: Conclusions:
| Original language | English |
|---|---|
| Pages (from-to) | 204-210 |
| Number of pages | 7 |
| Journal | Canadian Journal of Cardiology |
| Volume | 32 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 1 2016 |
Bibliographical note
Funding Information:The SPRINT-AF registry was supported by an investigator-initiated grant to Canadian Cardiovascular Research Network by Bayer Inc. Bayer Inc was not involved in the development or the execution of any component of this registry.
Funding Information:
A.C.T.H has served on an advisory board for Bayer and has received speaker's honoraria from Boeringher Ingelheim. N.S. has received speaker's honoraria from Boeringher Ingelheim and Bristol-Myers-Squibb and has received research funding from Boeringher Ingelheim and Janssen. J.L.C. has received speaker's honoraria from Bayer, Boehringer Ingelheim, Bristol-Myers-Squibb, and Pfizer and is a member of the Canadian Cardiovascular Society (CCS) AF Guidelines Committee and is Chair of the CCS AF Quality Indicators Committee. P.D. has received consulting fees and research funding from Bayer, Boehringer-Ingelheim, Bristol-Myers-Squibb, and Pfizer. C.F. has served on advisory boards for Boeringher Ingelheim, Bristol-Myers-Squibb, and Janssen and has received speaker's honoraria from Boeringher Ingelheim and Bristol-Myers-Squibb. E.L. has received consulting fees and speaker's honoraria from Bayer, Boehringer Ingelheim, and Bristol-Myers-Squibb. M.G. has received consulting fees and research funding from Bayer, Bristol-Myers-Squibb, and Pfizer. The other authors have no conflicts of interest to disclose.
Publisher Copyright:
© 2016 Canadian Cardiovascular Society.
ASJC Scopus Subject Areas
- Cardiology and Cardiovascular Medicine
