Rational Pharmacotherapy in Cardiology

Advanced search

The use of oral anticoagulants in patients with atrial fibrillation: cohort study data

Full Text:


Aim. To study the rate of prescription of oral anticoagulants (OAC) in patients with atrial fibrillation (AF) depending AF type and the reasons for their not-prescribing according to cohort study data.

Material and methods. Patients (n=58) with AF were included into the study. The rate of OAC, including new OAC (NOAC), prescription depending type AF and the reasons for their not-prescribing were studied.

Results. The rate of OAC use was 46.5% (warfarin – 22.4%, NOAC – 20.7%), antiplatelet agents use – 60.3%. The reasons for the lack of OAC use were: contraindications (high risk of hemorrhage or bleeding history) – 5.2%; patient’s inability to comply with the recommendations and the valvular AF, which does not allow to recommend NOAC – 25.8%; preference for a doctor based on the patient's refusal or preference – 22.4%. OAC use in patients with persistent AF was recorded significantly more frequently than in paroxysmal AF (85.71% vs 24.32%; χ2=17.9; p<0.0001).

Conclusions. A large part of patients with AF remains without OAC prescribing. More active use of NOAC will allow to correct current situation

About the Authors

O. V. Gaisenok
Joint Hospital and Polyclinic, Administrative Department of the President of the Russian Federation
Russian Federation
Michurinskiy prosp. 6, Moscow, 119285

A. S. Leonov
Joint Hospital and Polyclinic, Administrative Department of the President of the Russian Federation
Russian Federation
Michurinskiy prosp. 6, Moscow, 119285


1. Lefebvre MD, St-Onge M, Glazer-Cavanagh M, et al. The Effect of Bleeding Risk and Frailty Status on Anticoagulation Patterns in Octogenarians With Atrial Fibrillation: The FRAIL-AF Study. Can J Cardiol 2016;32(2):169-76.

2. Oldgren J, Healey JS, Ezekowitz M, et al.; RE-LY Atrial Fibrillation Registry Investigators. Variations in cause and management of atrial fibrillation in a prospective registry of 15,400 emergency department patients in 46 countries: the RE-LY Atrial Fibrillation Registry. Circulation 2014;129(15):1568-76.

3. Nieuwlaat R, Capucci A, Lip GY, et al.; EuroHeart Survey Investigators. Antithrombotic treatment in reallife atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation. Eur Heart J 2006;27(24):3018-26.

4. Linchak RM, Kompaniyets OG, Nedbaykin AM, et al. What Are the Realities of Prescription and Control of Antithrombotic Therapy in Atrial Fibrillation in Outpatient Practice? Kardiologiia 2015;55(6):34-9. In Russian (Линчак Р.М., Компаниец О.Г., Недбайкин А.М., и др. Каковы реалии назначения и контроля антитромботической терапии при фибрилляции предсердий в амбулаторной практике? Кардиология 2015; 6(55):34-9).

5. Lip GY, Larsen TB, Skjøth F, Rasmussen LH. Indirect Comparisons of New Oral Anticoagulant Drugs for Efficacy and Safety When Used for Stroke Prevention in Atrial Fibrillation. J Am Coll Cardiol 2012;60(8):738-46.

6. Tendera M, Syzdół M, Parma Z. ARISTOTLE RE-LYs on the ROCKET. What's new in stroke prevention in patients with atrial fibrillation? Cardiol J 2012;19(1):4-10.

7. Gaisenak OV, Leonov AS. Influence rhythm slows and antiarrhythmic therapy on the incidence of hospitalizations for atrial fibrillation. Vrach 2015; 3: 59-62. In Russian (Гайсенок О.В., Леонов А.С. Влияние ритм-урежающей и антиаритмической терапии на частоту госпитализаций при фибрилляции предсердий. Врач 2015;3:59-62).

8. National guidelines on the diagnosis and treatment of atrial fibrillation (2012). Available at: Retrieved 08/23/2016. In Russian (Национальные рекомендации по диагностике и лечению фибрилляции предсердий (2012). Доступно на:Проверено 23.08.2016).

9. Loukyanov MM, Boytsov SA, Jakushin CC, et al. Diagnosis, treatment, concomitant cardiovascular disease and comorbidities in patients with a diagnosis of "atrial fibrillation" in a real outpatient practice (according to register REKVAZAcardiovascular diseases). Rational Pharmacotherapy in Cardiology 2014; 10 (4): 366-77. In Russian (Лукьянов М.М., Бойцов С.А., Якушин C.C., и др. Диагностика, лечение, сочетанная сердечно-сосудистая патология и сопутствующие заболевания у больных с диагнозом «фибрилляция предсердий» в условиях реальной амбулаторно-поликлинической практики (по данным регистра кардиоваскулярных заболеваний РЕКВАЗА). Рациональная Фармакотерапия в Кардиологии 2014;10(4):366-77).

10. Sokolova A.A., Anikina O.S., Zhilenko A.V. et al. Anticoagulation treatment safety with vitamin K antagonists and novel oral anticoagulants within the registry of patients with non-valvular atrial fibrillation. Eur Heart J 2014; 35 Abstract Suppl: 1113.

11. Ehrlich AD, Davydenko MN, Maslova ES, Salyakhova TY. Atrial fibrillation (atrial fibrillation) and anticoagulant therapy with her in the Moscow city hospital. The one-day screening. Available at: Checked by 08/23/2016. In Russian (Эрлих А.Д., ДавыденкоМ.Н.,Маслова Е.С., Саляхова Т.Ю.Мерцательная аритмия (фибрилляция предсердий) и антикоагулянтная терапия при ней в московской городской больнице. Однодневный скрининг. Доступно на: Проверено 23.08.2016).

12. Martsevich SY, Navasardyan AR, Kutishenko NP, et al. The experience of studying atrial fibrillation based on the PROFILE register. Kardiovaskuljarnaja Terapija i Profilaktika 2014; 13 (2): 35-9. In Russian (Марцевич С. Ю., Навасардян А. Р., Кутишенко Н. П., и др. Опыт изучения фибрилляции предсердий на базе регистра ПРОФИЛЬ. Кардиоваскулярная Терапия и Профилактика 2014; 13 (2): 35-9).

13. O'Brien EC, Simon DN, Allen LA, et al. Reasons for Warfarin Discontinuation in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Am Heart J 2014;168(4):487-94.

14. De Caterina R, Hylek EM. Stroke prevention in atrial fibrillation: current status and near-future directions. Am J Med 2011;124(9):793-9.

15. Lip GY, Agnelli G, Thach AA, et al. Oral anticoagulation in atrial fibrillation: A pan-European patient survey. Eur J Intern Med 2007;18(3):202-8.

16. Connolly S.J., Ezekowitz M.D., Yusuf S. et al. Dabigatran versus warfarin in patients with atrial fibrillation. New Engl J Med 2009;361:1139—51.

17. Connolly S.J., Wallentin L., Ezekowitz M.D. et al. The Long Term Multi-Center Observational Study of Dabigatran Treatmentin PatientswithAtrial Fibrillation: (RELY-ABLE) Study.Circulation2013;128(3):237-43.

18. Larsen T.B., Rasmussen L.H., Skjoth F. et al. Efficacy and safety of dabigatran etexilate and warfarin in “real-world” patients with atrial fibrillation: a prospective nationwide cohort study. J Am Coll Cardiol 2013;61(22):2264-73.

19. Andrikopoulos G, Pastromas S, Mantas I, et al; MANAGE-AF Investigators. Management of atrial fibrillation in Greece: the MANAGE-AF study. Hellenic J Cardiol 2014;55(4):281-7.

20. Olesen JB, Sørensen R, Hansen ML, et al. Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naïve atrial fibrillation patients: Danish nationwide descriptive data 2011-2013. Europace 2015 Feb;17(2):187-93.

21. Patel MR, Mahaffey KW, Garg J, et al.: Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation. New England Journal of Medicine 2011 365(10):883-91.

22. Granger CB, Alexander JH, McMurray JJV, et al.: Apixaban versus Warfarin in Patients with Atrial Fibrillation. New England Journal of Medicine 2011; 365(11):981-92.

23. Eikelboom JW, Wallentin L, Connolly SJ, et al.: Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial. Сirculation 2011; 123(21):2363-72.

For citation:

Gaisenok O.V., Leonov A.S. The use of oral anticoagulants in patients with atrial fibrillation: cohort study data. Rational Pharmacotherapy in Cardiology. 2016;12(4):376-379. (In Russ.)

Views: 638

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)