title: Non-vitamin K antagonist oral anticoagulation usage according to age among patients with atrial fibrillation: Temporal trends 2011-2015 in Denmark.
abstract: Among atrial fibrillation (AF) patients, Danish nationwide registries (2011-2015) were used to examine temporal trends of initiation patterns of oral anticoagulation (OAC) treatment according to age. Overall, 43,299 AF patients initiating vitamin K antagonists (VKA) (42%), dabigatran (29%), rivaroxaban (13%), or apixaban (16%) were included with mean age (SD) 72.1 (11.3), 71.5 (11.0), 74.3 (11.1), and 75.3 (11.1) years, respectively. Patients aged ≥85 years comprised 15%. Trend tests showed increase in patients ≥85 years initiating OAC (p < 0.0001). VKA usage decreased from 92% to 24% (p < 0.0001). This decrease was independent of age. Dabigatran was the most common non-VKA OAC (NOAC) (40% users), but usage decreased from 2014 until study end (6%) (p < 0.0001). Apixaban was the most used OAC at study end (41%), in particular among those ≥85 years (44%). Compared with patients aged <65 years, the odds ratios associated with initiating VKA, dabigatran, rivaroxaban, or apixaban for patients aged ≥85 years were 0.81 (95% CI 0.75-0.86), 0.65 (95% CI 0.60-0.70), 1.52 (95% CI 1.38-1.67), and 2.09 (95% CI 1.89-2.30), respectively. In conclusion, substantial increase in NOAC usage has occurred. Increasing age was associated with upstart of rivaroxaban or apixaban with reference to age <65 within the specific agent.
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.
authors: Laila
authors: L
authors: Staerk
authors: Department of Cardiology, Rigshospitalet, 2100 Copenhagen Ø, Denmark.|The Danish Heart Foundation, 1127 Copenhagen K, Copenhagen, Denmark.
authors: Emil Loldrup
authors: EL
authors: Fosbøl
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.
authors: Kasper
authors: K
authors: Gadsbøll
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.
authors: Caroline
authors: C
authors: Sindet-Pedersen
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.
authors: Jannik Langtved
authors: JL
authors: Pallisgaard
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.
authors: Morten
authors: M
authors: Lamberts
authors: University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, United Kingdom.
authors: Gregory Y H
authors: GY
authors: Lip
authors: Institute of Health, Science and Technology, Aalborg University, 9100 Aalborg, Denmark.
authors: Christian
authors: C
authors: Torp-Pedersen
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.|The Danish Heart Foundation, 1127 Copenhagen K, Copenhagen, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark.|The National Institute of Public Health, University of Southern Denmark, 1353 Copenhagen K, Denmark.
authors: Gunnar Hilmar
authors: GH
authors: Gislason
authors: Department of Cardiology, Herlev and Gentofte University Hospital, 2900 Hellerup, Denmark.
authors: Jonas Bjerring
authors: JB
authors: Olesen
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000008:administration & dosage* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D000069604:Dabigatran / Q000008:administration & dosage / Q000627:therapeutic use; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011720:Pyrazoles / Q000008:administration & dosage / Q000627:therapeutic use; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use; D012042:Registries; D000069552:Rivaroxaban / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000991:Antithrombins; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran