title: Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation: FANTASIIA Study.
abstract: BACKGROUND
  Atrial fibrillation (AF) is associated with an increased risk of thromboembolic events. Many patients with AF receive chronic anticoagulation, either with vitamin K antagonists (VKAs) or with non-VKA oral anticoagulants (NOACs). We sought to analyze variables associated with prescription of NOAC.
  
  
  METHODS
  Patients with AF under anticoagulation treatment were prospectively recruited in this observational registry. The sample comprised 1290 patients under chronic anticoagulation for AF, 994 received VKA (77.1%) and 296 NOAC (22.9%). Univariate and multivariate analyses were performed to identify variables associated with use of NOAC.
  
  
  RESULTS
  Mean age was 73.8 ± 9.4 years, and 42.5% of the patients were women. The CHA2DS2-VASc score was 0 in 4.9% of the population, 1 in 24.1%, and ≥2 in 71% (median = 4, interquartile range = 2). Variables associated with NOAC treatment were major bleeding (odds ratio [OR] = 3.36; confidence interval [CI] 95%: 1.73-6.51; P < .001), hemorrhagic stroke (OR = 3.19; CI 95% 1.00-10.15, P = .049), university education (OR = 2.44; CI 95%: 1.55-3.84; P < .001), high diastolic blood pressure (OR = 1.02; CI 95%: 1.00-1.03; P = .006), and higher glomerular filtration rate (OR 1.01, CI 95% 1.00-1.01; P = .01). And variables associated with VKA use were history of cancer (OR = 0.46; CI 95%: 0.25-0.85; P = .013) and bradyarrhythmia (OR = 0.40; CI 95% 0.19-0.85; P = .020).
  
  
  CONCLUSIONS
  Medical and social variables were associated with prescription of NOAC. Major bleeding, hemorrhagic stroke, university education, and higher glomerular filtration rate were more frequent among patients under NOAC. On the contrary, patients with history of cancer or bradyarrhythmias more frequently received VKA.
authors.affiliation: Hospital Universitario de San Juan, Universidad Miguel Hernández, Alicante, Spain jmorarr@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Moreno-Arribas
authors.affiliation: Hospital Universitario de San Juan, Universidad Miguel Hernández, Alicante, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-González
authors.affiliation: Agencia de Investigación de la Sociedad Española de Cardiología, Madrid, Spain Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Anguita-Sanchez
authors.affiliation: Agencia de Investigación de la Sociedad Española de Cardiología, Madrid, Spain Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Cequier
authors.affiliation: Instituto Universitario de Ciencias de la Salud de la Universidad de A Coruña, Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Muñiz
authors.affiliation: Hospital Universitario de San Juan, Universidad Miguel Hernández, Alicante, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Castillo
authors.affiliation: Hospital Clínic de València, Universidad de Valencia, Valencia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.affiliation: Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Roldán
authors.affiliation: Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Marín
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-Martínez
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000066491:Clinical Decision-Making; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014812:Vitamin K
keywords: anticoagulant treatment; atrial fibrillation; nonvitamin K antagonist oral anticoagulants; vitamin K antagonists