title: Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation: experience at a Japanese single institution.
abstract: New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 %) patients were treated with NOACs and 109 (60 %) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Manaka
authors.initials: M
authors.lastname: Tagaya
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan. yodaiji_0526@yahoo.co.jp.|Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. yodaiji_0526@yahoo.co.jp.
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Sugishita
authors.affiliation: Hospital Pharmacy, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Yamauchi
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Tomohito
authors.initials: T
authors.lastname: Kamada
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Yoshinaga
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Mukaide
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Wakaya
authors.initials: W
authors.lastname: Fujiwara
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Hiroatsu
authors.initials: H
authors.lastname: Yokoi
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.|Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishii
authors.affiliation: Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.affiliation: Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, 454-0012, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Izawa
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000639:trends*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Anticoagulants; Arrhythmia; Atrial fibrillation; Drugs; Warfarin