Open AccessPersistence of non‐vitamin K antagonist oral anticoagulant use in Japanese patients with atrial fibrillation: A single‐center observational study
Author(s) -
Shiga Tsuyoshi,
Naganuma Miyoko,
Nagao Takehiko,
Maruyama Kenji,
Suzuki Atsushi,
Murasaki Kagari,
Hagiwara Nobuhisa
Publication year - 2015
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2015.04.004
Subject(s) - medicine , discontinuation , warfarin , apixaban , rivaroxaban , atrial fibrillation , dabigatran , vitamin k antagonist , adverse effect
Background Non‐vitamin K antagonist oral anticoagulants (NOACs) show a favorable balance between efficacy and safety compared with warfarin for patients with non‐valvular atrial fibrillation (NVAF). In “real‐world” practice, however, NOAC adherence and persistence among patients are not clear. The aim of this study is to evaluate NOAC and warfarin persistence in Japanese patients with NVAF who newly started these drugs. Methods We retrospectively studied 401 patients with NVAF who had newly started NOACs during the first 18 months after our hospital adopted their use (197 dabigatran, 107 rivaroxaban, 102 apixaban) and 200 patients with NVAF who had newly started warfarin during the same period. The endpoint was drug discontinuation for each drug. Results During the follow‐up period (up to a maximum of 24 months), 113 (28%) patients who had newly started NOACs and 33 (17%) patients who had newly started warfarin discontinued the drug. The persistence rates of patients prescribed NOACs was lower than that of patients prescribed warfarin at 3, 6, and 12 months (85% versus 93%, 79% versus 88%, and 70% versus 82%, respectively). One‐tenth of patients who had newly started NOACs discontinued the drug by their own decision. Drug adverse events, worsening renal dysfunction, and patient desire were the major causes of NOAC discontinuation. Conclusions The rate of persistence of prescribed NOACs was significantly lower than that of warfarin in Japanese patients with NVAF.