Matylda Zimny1, Steffen Blum2, Peter Ammann3, Paul Erne4, Giorgio Moschovitis5, Marcello Di Valentino6, Dipen Shah7, Jürg Schläpfer, Cyrill Vogt8, Alexandra Tabord9, Michael Kühne10, Christian Sticherling11, Stefan Osswald11, David Conen12. 1. Department of Medicine, University Hospital Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland. 2. Department of Medicine, University Hospital Basel, Switzerland; b Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Division of Cardiology, University Hospital Basel, Switzerland. 3. Division of Cardiology, Kantonsspital St. Gallen, Switzerland. 4. Lab Signal Transduction, Department of Biomedicine, University of Basel, Switzerland. 5. Division of Cardiology, Ospedale Regionale di Lugano, Ticino, Switzerland. 6. Division of Cardiology, Ospedale San Giovanni di Bellinzona, Ticino, Switzerland. 7. Division of Cardiology, University Hospital Geneva, Switzerland. 8. Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland. 9. Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Department of Medicine, Regionalspital Surselva, Graubünden, Switzerland. 10. Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; c Division of Cardiology, University Hospital Basel, Switzerland. 11. Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Division of Cardiology, University Hospital Basel, Switzerland. 12. Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Division of Cardiology, University Hospital Basel, Switzerland; Population Health Research Institute, McMaster University, Hamilton, Canada.
Abstract
AIMS: We aimed to assess the uptake of non-vitamin K antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation between 2010 and 2015 in Switzerland. METHODS: We performed a prospective observational cohort study. At the baseline examination and during yearly follow-ups, we used questionnaires to obtain information about clinical characteristics and antithrombotic treatment. Stroke risk was assessed using the CHA2DS2-VASc score. RESULTS: 1545 patients were enrolled across seven centres in Switzerland. Mean age was 68 ± 12 years and 29.5% were female. The percentage of anticoagulated patients with an indication for oral anticoagulation (CHA2DS2-VASc score ≥2 in women and ≥1 in men) was 75% in 2010 and 80% in 2015 (p = 0.2). There was a gradual increase in the use of NOACs from 0% in 2010 to 29.8% in 2015 (p <0.0001). Out of 888 patients, who initially received a vitamin K antagonist (VKA), 86 (9.7%) were switched to an NOAC during follow-up. Use of aspirin as a monotherapy decreased from 23% in 2010 to 11% in 2015 (p <0.0001). CONCLUSION: After regulatory approval, the use of NOACs in Switzerland steadily increased to about 30% in 2015, whereas switches from VKAs to NOACs were infrequent. In parallel, the prescription of aspirin as monotherapy was more than halved, suggesting significant guideline-concordant improvements in oral anticoagulation use among patients with atrial fibrillation.
AIMS: We aimed to assess the uptake of non-vitamin K antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation between 2010 and 2015 in Switzerland. METHODS: We performed a prospective observational cohort study. At the baseline examination and during yearly follow-ups, we used questionnaires to obtain information about clinical characteristics and antithrombotic treatment. Stroke risk was assessed using the CHA2DS2-VASc score. RESULTS: 1545 patients were enrolled across seven centres in Switzerland. Mean age was 68 ± 12 years and 29.5% were female. The percentage of anticoagulated patients with an indication for oral anticoagulation (CHA2DS2-VASc score ≥2 in women and ≥1 in men) was 75% in 2010 and 80% in 2015 (p = 0.2). There was a gradual increase in the use of NOACs from 0% in 2010 to 29.8% in 2015 (p <0.0001). Out of 888 patients, who initially received a vitamin K antagonist (VKA), 86 (9.7%) were switched to an NOAC during follow-up. Use of aspirin as a monotherapy decreased from 23% in 2010 to 11% in 2015 (p <0.0001). CONCLUSION: After regulatory approval, the use of NOACs in Switzerland steadily increased to about 30% in 2015, whereas switches from VKAs to NOACs were infrequent. In parallel, the prescription of aspirin as monotherapy was more than halved, suggesting significant guideline-concordant improvements in oral anticoagulation use among patients with atrial fibrillation.
Authors: F Russell Quinn; David J Gladstone; Noah M Ivers; Roopinder K Sandhu; Lisa Dolovich; Andrea Ling; Juliet Nakamya; Chinthanie Ramasundarahettige; Paul A Frydrych; Sam Henein; Ken Ng; Valerie Congdon; Richard V Birtwhistle; Richard Ward; Jeffrey S Healey Journal: CMAJ Open Date: 2018-08-02
Authors: Steffen Blum; Stefanie Aeschbacher; Michael Coslovsky; Pascal B Meyre; Philipp Reddiess; Peter Ammann; Paul Erne; Giorgio Moschovitis; Marcello Di Valentino; Dipen Shah; Jürg Schläpfer; Rahel Müller; Jürg H Beer; Richard Kobza; Leo H Bonati; Elisavet Moutzouri; Nicolas Rodondi; Christine Meyer-Zürn; Michael Kühne; Christian Sticherling; Stefan Osswald; David Conen Journal: Sci Rep Date: 2022-02-09 Impact factor: 4.379