Arrhythmias & electrophysiologyCohort study
Characteristics of patients with atrial fibrillation treated with direct oral anticoagulants and new insights into inappropriate dosing: results from the French National Prospective Registry: PAFF
- Prospective registry study
- national
Authors' conclusion
Within this large registry, DOACs were associated with inappropriate dosing in 18% of cases. Independent predictors of inappropriate dosing were high CHA2DS2VASc scores and older age. Moreover, 46% of patients treated with low-dose DOACs were inappropriately underdosed and more frequently in patients treated with apixaban.
Study context
- Population
- Patients with Atrial Fibrillation (AF) receiving Direct Oral Anticoagulant (DOACs), French National Prospective Registry (PAFF), October 2021 to December 2021
- Participants
- 1,890 patients
- Exposure
- Appropriate vs inappropriate DOAC dosing
- Outcome
- Inappropriate DOAC dosing and characteristics of patients with inappropriate and low-dose DOACs
Main finding
As reported in the abstract
Inappropriate DOAC dosing
- Inappropriate dosing (% of population)
- 18%
- Age, appropriate vs inappropriate dosing (years)
- 75 ± 10 vs. 82 ± 8, P < 0.0001
- Chronic renal failure, appropriate vs inappropriate dosing
- 26 vs. 61%, P < 0.0001
- CHA2DS2VASc score, appropriate vs inappropriate dosing
- 3 ± 2 vs. 4 ± 3, P < 0.0001
- HASBLED score, appropriate vs inappropriate dosing
- 2 ±1 vs. 2 ± 2, P < 0.0001
- Independent predictor of inappropriate dosing (multivariate): older age
- P < 0.0001
- Independent predictor of inappropriate dosing (multivariate): higher CHA2DS2VASc score
- P = 0.0056
Observational data: associations, not effects.
Further findings
Inappropriate underdosing among low-dose rivaroxaban or apixaban (n = 472, 27%)
- Inappropriately underdosed
- 46%
- Age, underdosed vs appropriately low-dosed (years)
- 82.3 ± 8.4 vs. 85.9 ± 5.9, P < 0.0001
- Chronic renal disease, underdosed vs appropriately low-dosed
- 47 vs. 98%, P < 0.0001
- Prior haemorrhagic events, underdosed vs appropriately low-dosed
- 18 vs. 10%, P = 0.01
- Clopidogrel use, underdosed vs appropriately low-dosed
- 11 vs. 3%, P = 0.0002
- Apixaban prescription, underdosed vs appropriately low-dosed
- 74 vs. 50%, P < 0.0001
Original publication
Characteristics of patients with atrial fibrillation treated with direct oral anticoagulants and new insights into inappropriate dosing: results from the French National Prospective Registry: PAFF. Europace. Published 6 October 2023. doi:10.1093/europace/euad302
Summarised from the published abstract; every number is checked against it