PROHLÍŽENÍ ABSTRAKTA

HOW DO WE USE ANTITHROMBOTIC THERAPY INCLUDING NOVEL ORAL ANTICOAGULANTS IN THE MANAGEMENT OF ATRIAL FIBRILLATION: RESULTS FROM THE FIRST II REGISTRY
Tématický okruh: Farmakoterapie
Typ: Poster - lékařský , Číslo v programu: 547

Prýmková L.1, Nováková T.1, Felšöci M.1, Jarkovský J.2, Špinar J.1

1 IKK, FN Brno, Brno, 2 Institut biostatistiky a analýz, Masarykova univerzita, Brno


Aim:Novel oral anticoagulants (NOACs) in the treatment of atrial fibrillation (AF) entered clinical practice in recent years, nevertheless data from daily clinical use are still missing. This work aims to compare NOACs with other antithrombotics in AF.

Methods:We enrolled 1059 hospitalized patients with history of AF:treated with warfarin (W, 43.2%, N=458), NOACs (9.5%, N=98), low molecular weight heparin (LMWH, 8.4%, N=90) and population with antiplatelet medication or even without any anticoagulation therapy (AA/NO, 38.9%, N=413).

Results:Patients with warfarin were younger (70.3 years vs. 75.4 in NOACs and 77.9 in AA/NO, p<0.001), had better renal function (creatinine clearance 60.4 ml/min vs. 53.4 in NOACs and 54.7 in AA/NO, p<0.05) and highest BMI (29 kg/m2, vs. all p<0.05). No difference was observed in the incidence of stroke (15.1% W, 21.4% NOACs, 14.8% AA/NO, 18.9% LMWH, p=NS). Patients treated with LMWH had higher occurrence of oncological diseases (18.9% vs. 5.9% in W, p<0.05). Patients treated with NOACs had higher CHA2DS2-VASc score (4.2±1.8) than W group (3.6±1.9, p<0.05). Population using warfarin had the lowest HAS-BLED score (2.1±1.1 vs. 2.4±1.1 in NOACs, 3.0±1.2 AA/NO and 2.8±1.3 in LMWH, p<0.05). Patients treated with NOACs had higher occurrence of labile INR values in history (20.4% vs. 5.0% in W, p<0.05). Patients in AA/NO and LMWH group suffered more from bleeding events in the past (13.3% and 32.2% respectively, vs. 2.6% in W, p<0.05).

Conclusion:The majority of patients with history of AF are treated with warfarin. Warfarin is used in younger patients with better renal functions and lower risk of bleeding. Patients using NOACs are older, have higher value of CHA2DS2-VASc score and worse INR control in history. Patients without anticoagulation therapy or using LMWH have higher incidence of bleeding events in the past.