Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?—Results of the Polish Atrial Fibrillation (POL-AF) Registry

Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicen...

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Published inInternational journal of environmental research and public health Vol. 19; no. 19; p. 11939
Main Authors Szyszkowska, Anna, Kuźma, Łukasz, Wożakowska-Kapłon, Beata, Gorczyca-Głowacka, Iwona, Jelonek, Olga, Uziębło-Życzkowska, Beata, Krzesiński, Paweł, Wójcik, Maciej, Błaszczyk, Robert, Gawałko, Monika, Kapłon-Cieślicka, Agnieszka, Tokarek, Tomasz, Rajtar-Salwa, Renata, Bil, Jacek, Wojewódzki, Michał, Szpotowicz, Anna, Krzciuk, Małgorzata, Bednarski, Janusz, Bakuła, Elwira, Wełnicki, Marcin, Mamcarz, Artur, Tomaszuk-Kazberuk, Anna
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 21.09.2022
MDPI
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Online AccessGet full text
ISSN1660-4601
1661-7827
1660-4601
DOI10.3390/ijerph191911939

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Abstract Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA2DS2-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use—out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
AbstractList The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants).BACKGROUNDThe aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants).The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past.METHODSThe Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past.Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA2DS2-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use-out of reduced dosage groups, p = 0.06).RESULTSAmong 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA2DS2-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use-out of reduced dosage groups, p = 0.06).A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.CONCLUSIONSA significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA DS -VASc score (median score 7 vs. 4, < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use-out of reduced dosage groups, = 0.06). A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA2DS2-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use—out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA 2 DS 2 -VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use—out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
Author Jelonek, Olga
Tomaszuk-Kazberuk, Anna
Błaszczyk, Robert
Szpotowicz, Anna
Bednarski, Janusz
Bakuła, Elwira
Mamcarz, Artur
Kuźma, Łukasz
Wożakowska-Kapłon, Beata
Uziębło-Życzkowska, Beata
Krzesiński, Paweł
Rajtar-Salwa, Renata
Bil, Jacek
Krzciuk, Małgorzata
Wełnicki, Marcin
Wójcik, Maciej
Szyszkowska, Anna
Tokarek, Tomasz
Gawałko, Monika
Gorczyca-Głowacka, Iwona
Wojewódzki, Michał
Kapłon-Cieślicka, Agnieszka
AuthorAffiliation 6 Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland
2 Department of Invasive Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland
12 Department of Invasive Cardiology, Center of Postgraduate Medical Education, 02-776 Warsaw, Poland
14 Department of Cardiology, St. John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland
4 Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
3 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
1 Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland
7 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
10 Center for Invasive Cardiology, Electrotherapy and Angiology, 38-400 Nowy Sacz, Poland
13 Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland
9 Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, 45147 Essen,
AuthorAffiliation_xml – name: 3 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
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2022 by the authors. 2022
Copyright_xml – notice: 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Issue 19
Keywords atrial fibrillation
reduced dose
ischemic stroke
anticoagulation
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PublicationTitle International journal of environmental research and public health
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Snippet Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced...
The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs...
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StartPage 11939
SubjectTerms Administration, Oral
Anticoagulants
Atrial Fibrillation - chemically induced
Atrial Fibrillation - drug therapy
Atrial Fibrillation - epidemiology
Cardiac arrhythmia
Cardiovascular disease
Dabigatran - adverse effects
Dabigatran - therapeutic use
Embolisms
Fibrinolytic Agents - therapeutic use
Heart attacks
Humans
Ischemic Stroke
Kidney diseases
Mortality
Patients
Poland - epidemiology
Population
Prospective Studies
Pyridones
Registries
Rivaroxaban - adverse effects
Stroke
Vein & artery diseases
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Title Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?—Results of the Polish Atrial Fibrillation (POL-AF) Registry
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