Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai
Abstracts: Objective: To summarize the use rate, safety, efficacy of antithrombotics in stroke/transient ischemic attack (TIA) prevention, and reasons for not using dabigatran etexilate (DE) in Shanghai, China. Methods: Non-valvular atrial fibrillation (NVAF)-associated stroke patients were prospec...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2015-12-01
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| Series: | Chronic Diseases and Translational Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095882X15000717 |
| _version_ | 1818233954076983296 |
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| author | Feng-Di Liu Rong Zhao Xue-Mei Wang Shuo Wang Xiao-Lei Shen Xiao-Xiao Tao Bo Zheng Jia-Li Peng Hui Zhang Ran Mo Yan Tong Wen-Ting Li Xiao-Yan Feng Ge-Fei Li Liang Shu Jian-Ren Liu |
| author_facet | Feng-Di Liu Rong Zhao Xue-Mei Wang Shuo Wang Xiao-Lei Shen Xiao-Xiao Tao Bo Zheng Jia-Li Peng Hui Zhang Ran Mo Yan Tong Wen-Ting Li Xiao-Yan Feng Ge-Fei Li Liang Shu Jian-Ren Liu |
| author_sort | Feng-Di Liu |
| collection | DOAJ |
| description | Abstracts: Objective: To summarize the use rate, safety, efficacy of antithrombotics in stroke/transient ischemic attack (TIA) prevention, and reasons for not using dabigatran etexilate (DE) in Shanghai, China. Methods: Non-valvular atrial fibrillation (NVAF)-associated stroke patients were prospectively registered as an electronic database. Use rate of antithrombotics and reasons for not using DE were extracted during follow-up. Patients' baseline characteristics, recurrent ischemic stroke/TIA events and bleeding complications were analyzed. Patients: From April 2012 to August 2014, 110 inpatients with NVAF-associated stroke were studied in our hospital. NVAF was diagnosed by 12-lead electrocardiogram, 24 h Holter and echocardiography. Results: Before introduction of DE (April 2013), use rates of warfarin and antiplatelets were 28.9% (11/38) and 60.5% (23/38) respectively; after that, use rates of warfarin, DE, and antiplatelets were 20.8% (15/72), 12.5% (9/72), and 43.1% (31/72). The DE did not improve use of anticoagulants (P = 0.639). There were 19 (17.3%) recurrent ischemic stroke events up to October 2015; two (9.5%) in the non-user group, 10 (18.5%) in the antiplatelet group, and seven (20.0%) in the anticoagulants group (P = 0.570). Furthermore, recurrence rates were similar between the DE group (20.0%) and the Warfarin group (20.0%, P = 1.000). The most common reason for not using DE was financial concerns (61.0%), followed by inconvenience to purchase (14.0%) and hemorrhage concerns (11.0%). Two patients using warfarin found fecal occult blood so they stopped warfarin and began to use antiplatelet drugs. No bleeding event occurred in the other groups. Only one patient had side effects (dyspepsia and gastroesophageal reflux) from DE. Conclusion: The use rate of either DE or warfarin in Shanghai was low; DE had not improved anticoagulation therapy for NVAF patients in Shanghai mainly because DE had not been covered by health insurance. Keywords: Dabigatran etexilate, Novel oral anticoagulant, Cardiogenic cerebral embolism, Non-valvular atrial fibrillation, Real-world study |
| first_indexed | 2024-12-12T11:30:23Z |
| format | Article |
| id | doaj.art-118a427805ec498eb9fa0c460219d6ea |
| institution | Directory Open Access Journal |
| issn | 2095-882X |
| language | English |
| last_indexed | 2024-12-12T11:30:23Z |
| publishDate | 2015-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Chronic Diseases and Translational Medicine |
| spelling | doaj.art-118a427805ec498eb9fa0c460219d6ea2022-12-22T00:25:47ZengWileyChronic Diseases and Translational Medicine2095-882X2015-12-0114203209Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in ShanghaiFeng-Di Liu0Rong Zhao1Xue-Mei Wang2Shuo Wang3Xiao-Lei Shen4Xiao-Xiao Tao5Bo Zheng6Jia-Li Peng7Hui Zhang8Ran Mo9Yan Tong10Wen-Ting Li11Xiao-Yan Feng12Ge-Fei Li13Liang Shu14Jian-Ren Liu15Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaDepartment of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaCorresponding author. 639 Zhizaoju Road, Huangpu District, Shanghai, China, 200011. Tel.: +86 21 6308 1475.; Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaCorresponding author. 639 Zhizaoju Road, Huangpu District, Shanghai, China, 200011. Tel.: +86 21 6308 1475.; Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, ChinaAbstracts: Objective: To summarize the use rate, safety, efficacy of antithrombotics in stroke/transient ischemic attack (TIA) prevention, and reasons for not using dabigatran etexilate (DE) in Shanghai, China. Methods: Non-valvular atrial fibrillation (NVAF)-associated stroke patients were prospectively registered as an electronic database. Use rate of antithrombotics and reasons for not using DE were extracted during follow-up. Patients' baseline characteristics, recurrent ischemic stroke/TIA events and bleeding complications were analyzed. Patients: From April 2012 to August 2014, 110 inpatients with NVAF-associated stroke were studied in our hospital. NVAF was diagnosed by 12-lead electrocardiogram, 24 h Holter and echocardiography. Results: Before introduction of DE (April 2013), use rates of warfarin and antiplatelets were 28.9% (11/38) and 60.5% (23/38) respectively; after that, use rates of warfarin, DE, and antiplatelets were 20.8% (15/72), 12.5% (9/72), and 43.1% (31/72). The DE did not improve use of anticoagulants (P = 0.639). There were 19 (17.3%) recurrent ischemic stroke events up to October 2015; two (9.5%) in the non-user group, 10 (18.5%) in the antiplatelet group, and seven (20.0%) in the anticoagulants group (P = 0.570). Furthermore, recurrence rates were similar between the DE group (20.0%) and the Warfarin group (20.0%, P = 1.000). The most common reason for not using DE was financial concerns (61.0%), followed by inconvenience to purchase (14.0%) and hemorrhage concerns (11.0%). Two patients using warfarin found fecal occult blood so they stopped warfarin and began to use antiplatelet drugs. No bleeding event occurred in the other groups. Only one patient had side effects (dyspepsia and gastroesophageal reflux) from DE. Conclusion: The use rate of either DE or warfarin in Shanghai was low; DE had not improved anticoagulation therapy for NVAF patients in Shanghai mainly because DE had not been covered by health insurance. Keywords: Dabigatran etexilate, Novel oral anticoagulant, Cardiogenic cerebral embolism, Non-valvular atrial fibrillation, Real-world studyhttp://www.sciencedirect.com/science/article/pii/S2095882X15000717 |
| spellingShingle | Feng-Di Liu Rong Zhao Xue-Mei Wang Shuo Wang Xiao-Lei Shen Xiao-Xiao Tao Bo Zheng Jia-Li Peng Hui Zhang Ran Mo Yan Tong Wen-Ting Li Xiao-Yan Feng Ge-Fei Li Liang Shu Jian-Ren Liu Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai Chronic Diseases and Translational Medicine |
| title | Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai |
| title_full | Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai |
| title_fullStr | Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai |
| title_full_unstemmed | Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai |
| title_short | Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai |
| title_sort | does novel oral anticoagulant improve anticoagulation for non valvular atrial fibrillation associated stroke an inpatient registration study in shanghai |
| url | http://www.sciencedirect.com/science/article/pii/S2095882X15000717 |
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