TY - JOUR
T1 - Non-vitamin K antagonist oral anticoagulation usage according to age among patients with atrial fibrillation
T2 - Temporal trends 2011-2015 in Denmark
AU - Staerk, Laila
AU - Fosbøl, Emil Loldrup
AU - Gadsbøll, Kasper
AU - Sindet-Pedersen, Caroline
AU - Pallisgaard, Jannik Langtved
AU - Lamberts, Morten
AU - Lip, Gregory Y H
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar Hilmar
AU - Olesen, Jonas Bjerring
PY - 2016
Y1 - 2016
N2 - Among atrial fibrillation (AF) patients, Danish nationwide registries (2011-2015) were used to examine temporal trends of initiation patterns of oral anticoagulation (OAC) treatment according to age. Overall, 43,299 AF patients initiating vitamin K antagonists (VKA) (42%), dabigatran (29%), rivaroxaban (13%), or apixaban (16%) were included with mean age (SD) 72.1 (11.3), 71.5 (11.0), 74.3 (11.1), and 75.3 (11.1) years, respectively. Patients aged ≥85 years comprised 15%. Trend tests showed increase in patients ≥85 years initiating OAC (p < 0.0001). VKA usage decreased from 92% to 24% (p < 0.0001). This decrease was independent of age. Dabigatran was the most common non-VKA OAC (NOAC) (40% users), but usage decreased from 2014 until study end (6%) (p < 0.0001). Apixaban was the most used OAC at study end (41%), in particular among those ≥85 years (44%). Compared with patients aged <65 years, the odds ratios associated with initiating VKA, dabigatran, rivaroxaban, or apixaban for patients aged ≥85 years were 0.81 (95% CI 0.75-0.86), 0.65 (95% CI 0.60-0.70), 1.52 (95% CI 1.38-1.67), and 2.09 (95% CI 1.89-2.30), respectively. In conclusion, substantial increase in NOAC usage has occurred. Increasing age was associated with upstart of rivaroxaban or apixaban with reference to age <65 within the specific agent.
AB - Among atrial fibrillation (AF) patients, Danish nationwide registries (2011-2015) were used to examine temporal trends of initiation patterns of oral anticoagulation (OAC) treatment according to age. Overall, 43,299 AF patients initiating vitamin K antagonists (VKA) (42%), dabigatran (29%), rivaroxaban (13%), or apixaban (16%) were included with mean age (SD) 72.1 (11.3), 71.5 (11.0), 74.3 (11.1), and 75.3 (11.1) years, respectively. Patients aged ≥85 years comprised 15%. Trend tests showed increase in patients ≥85 years initiating OAC (p < 0.0001). VKA usage decreased from 92% to 24% (p < 0.0001). This decrease was independent of age. Dabigatran was the most common non-VKA OAC (NOAC) (40% users), but usage decreased from 2014 until study end (6%) (p < 0.0001). Apixaban was the most used OAC at study end (41%), in particular among those ≥85 years (44%). Compared with patients aged <65 years, the odds ratios associated with initiating VKA, dabigatran, rivaroxaban, or apixaban for patients aged ≥85 years were 0.81 (95% CI 0.75-0.86), 0.65 (95% CI 0.60-0.70), 1.52 (95% CI 1.38-1.67), and 2.09 (95% CI 1.89-2.30), respectively. In conclusion, substantial increase in NOAC usage has occurred. Increasing age was associated with upstart of rivaroxaban or apixaban with reference to age <65 within the specific agent.
U2 - 10.1038/srep31477
DO - 10.1038/srep31477
M3 - Journal article
C2 - 27510920
VL - 6
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
M1 - 31477
ER -