Long-Term Persistence with Newly-Initiated Warfarin or Non-VKA Oral Anticoagulant (NOAC) in Patients with Non-Valvular Atrial Fibrillation: Insights from the Prospective China-AF Registry
机构:[1]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, P.R. China临床科室心脏内科中心首都医科大学附属安贞医院[2]Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom[3]Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Background: Oral anticoagulants (OACs) such as warfarin and non-VKA oral anticoagulants (NOACs) have been recommended for patients with atrial fibrillation (AF) who are at risk for stroke. Whether NOACs have a higher persistence than warfarin is still unclear. This is especially true in China. Material/Methods: Data from a large hospital-based cohort in China (China-AF Registry) from 2011 to 2017 were used for this study. Non-valvular AF patients with newly initiated OACs were included. A time-to-event approach was used to analyze patient persistence. The survival distributions of persistence were compared using the log-rank test. A multivariable Cox regression model was used to explore predictors of warfarin and NOACs non-persistence. Results: Patients with newly initiated warfarin (n=4845) or NOACs (n=854) were included in this study. Persistence rates at 1, 2, and 3 years were 93.2%, 89.4%, and 87.2% in the warfarin group and 88.8%, 84.3%, and 81.3% in the NOAC group respectively. Non-persistence was significantly higher with NOACs than with warfarin. On multivariate analysis, age <75 years old, outpatient clinic visits, asymptomatic AF, paroxysmal AF, duration of AF <3 years, history of peptic ulcer, and no previous TIA, stroke or thromboembolism were strong predictors of warfarin non-persistence, while in the NOACs group, age <75 years old, outpatient clinic visits, lower education status and no history of congestive heart failure were predictors. Conclusions: Treatment persistence of NOACs was lower than that of warfarin among Chinese patients with AF. Patients with characteristics of non-persistence predictors need special attention to maintain their therapy.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2013BAI09B02]; Beijing Municipal Commission of Science and Technology [ZYLX201302, D111100003011004, D131100002313001]; Bristol-Myers SquibbBristol-Myers Squibb; PfizerPfizer; Johnson JohnsonJohnson & Johnson USA; Boehringer-IngelheimBoehringer Ingelheim; BayerBayer AG
第一作者机构:[1]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, P.R. China
通讯作者:
通讯机构:[1]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, P.R. China
推荐引用方式(GB/T 7714):
Chang Liu,Xin Du,Chao Jiang,et al.Long-Term Persistence with Newly-Initiated Warfarin or Non-VKA Oral Anticoagulant (NOAC) in Patients with Non-Valvular Atrial Fibrillation: Insights from the Prospective China-AF Registry[J].MEDICAL SCIENCE MONITOR.2019,25:2649-2657.doi:10.12659/MSM.915875.
APA:
Chang Liu,Xin Du,Chao Jiang,Liu He,San-Shuai Chang...&Chang-Sheng Ma.(2019).Long-Term Persistence with Newly-Initiated Warfarin or Non-VKA Oral Anticoagulant (NOAC) in Patients with Non-Valvular Atrial Fibrillation: Insights from the Prospective China-AF Registry.MEDICAL SCIENCE MONITOR,25,
MLA:
Chang Liu,et al."Long-Term Persistence with Newly-Initiated Warfarin or Non-VKA Oral Anticoagulant (NOAC) in Patients with Non-Valvular Atrial Fibrillation: Insights from the Prospective China-AF Registry".MEDICAL SCIENCE MONITOR 25.(2019):2649-2657