title: Prescription of oral anticoagulation for patients with atrial fibrillation and previous hospitalization in a cardiology department. Experience in actual practice in a tertiary hospital.
abstract: BACKGROUND
  Atrial fibrillation is the main reason for oral anticoagulation in our community. New oral anticoagulants (NOACs) overcome the disadvantages of vitamin K antagonists (VKAs), although there are scarce data on its use in our community. The aim of our study was to assess the use of NOACs and anticoagulation control using VKA as measured by the time within the therapeutic range (TTR) in an actual clinical scenario.
  
  
  METHODS
  A retrospective cohort analysis was conducted of 816 patients admitted to cardiology over a period of 3 years, with a diagnosis of atrial fibrillation and anticoagulant treatment at discharge. We assessed the percentage of patients prescribed NOACs and the TTR with VKA. We compared safety and efficacy events during the 15-month follow-up among the patients prescribed NOAC, those prescribed VKA with a good TTR and those with a poor TTR.
  
  
  RESULTS
  The percentage of patients prescribed NOAC was 7.6%. Serial INR measurements found that 71.3% of patients had a poor TTR. Although the groups were not comparable, a higher incidence of the combined event was observed in those treated with VKA and a poor TTR compared with those prescribed NOAC (p=.01).
  
  
  CONCLUSIONS
  For patients with a previous hospitalization in cardiology in a tertiary hospital and a diagnosis of atrial fibrillation, the rate of NOAC prescription is low, and the TTR with VKA was poor.
authors: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, España; Fundación para la Investigación, Hospital General Universitario de Valencia, Valencia, España. Electronic address: osfabregat@gmail.com.
authors: Ó
authors: Ó
authors: Fabregat-Andrés
authors: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors: A
authors: A
authors: Cubillos-Arango
authors: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors: N
authors: N
authors: Chacón-Hernández
authors: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors: V
authors: V
authors: Montagud
authors: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors: S
authors: S
authors: Morell
authors: Servicio de Cardiología, Consorcio Hospital General Universitario de Valencia, Valencia, España.
authors: L
authors: L
authors: Fácila
keywords: Anticoagulación oral; Atrial fibrillation; Fibrilación auricular; Hospitalization; Ingreso hospitalario; Novel anticoagulant agents; Nuevos anticoagulantes orales; Oral anticoagulation