Predictors, time course, and outcomes of persistence patterns in oral anticoagulation for non-valvular atrial fibrillation: a Dutch Nationwide Cohort Study
Authors' conclusion
At least a quarter of NVAF patients were non-persistent with OACs within 4 years, which was associated with poor efficacy of ischaemic stroke prevention.
Study context
- Population
- DOAC-naive non-valvular atrial fibrillation (NVAF) patients starting direct oral anticoagulants (DOACs) for ischaemic stroke prevention, Netherlands, 2013–201875.7% CHA2DS2-VASc ≥2
- Participants
- 93,048 patients
- Exposure
- Non-persistence vs persistence with oral anticoagulants (OACs)
- Outcome
- Persistence with OACs (cumulative incidence)
- Follow-up
- 1, 2, 3 and 4 years after receiving DOACs
Main finding
As reported in the abstract
Cumulative incidence of persistence with OACs
Persistence at 1 year
88.1%
95% CI 87.9–88.3%
Persistence at 2 years
82.6%
95% CI 82.3–82.9%
Persistence at 3 years
77.7%
95% CI 77.3–78.1%
Persistence at 4 years
72.0%
95% CI 71.5–72.5%
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Composite of ischaemic stroke and ischaemic stroke-related death | 1.79 (1.49–2.15) | |
| Ischaemic stroke | 1.58 (1.29–1.93) | |
| 0.512Adjusted hazard ratio (log scale) |
Baseline predictors of better persistence
- Female sex, age 65-74 years, permanent AF, previous VKA exposure, stroke history (incl. TIA), CHA2DS2-VASc ≥2
Original publication
Predictors, time course, and outcomes of persistence patterns in oral anticoagulation for non-valvular atrial fibrillation: a Dutch Nationwide Cohort Study. Eur Heart J. Published 16 July 2021. doi:10.
Summarised from the published abstract; every number is checked against it