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Cardiovascular Drugs and Therapy
Published in: Cardiovascular Drugs and Therapy 3/2024

17-12-2022 | Dabigatran | Original Article

PrevAleNce and Associated factors of inappropriaTe dosing of direct Oral anticoaguLants In pAtients with Atrial Fibrillation: the ANATOLIA-AF Study

Authors: Umut Kocabaş, Isil Ergin, Veysel Yavuz, Selda Murat, Ibrahim Özdemir, Ömer Genç, Cihan Altın, Haşim Tüner, Bengisu Keskin Meriç, Ali Çoner, Elif İlkay Yüce, Bedrettin Boyraz, Onur Aslan, Ahmet Dal, Taner Şen, Ersin İbişoğlu, Aslan Erdoğan, Mehmet Özgeyik, Mevlüt Demir, Ziya Gökalp Bilgel, Büşra Güvendi Şengör, Örsan Deniz Urgun, Mustafa Doğduş, Deniz Dilan Naki Tekin, Sinem Çakal, Sercan Çayırlı, Arda Güler, Dilay Karabulut, Onur Dalgıç, Osman Uzman, Bektaş Murat, Şeyda Şahin, Umut Karabulut, Tarık Kıvrak, Muharrem Said Coşgun, Ferhat Özyurtlu, Mehmet Kaplan, Emre Özçalık, on behalf of the ANATOLIA-AF . study investigators

Published in: Cardiovascular Drugs and Therapy | Issue 3/2024

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Abstract 

Purpose

Inappropriate dosing of direct oral anticoagulants is associated with an increased risk of stroke, systemic embolism, major bleeding, cardiovascular hospitalization, and death in patients with atrial fibrillation. The main goal of the study was to determine the prevalence and associated factors of inappropriate dosing of direct oral anticoagulants in real-life settings.

Methods

This study was a multicenter, cross-sectional, observational study that included 2004 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January and May 2021. The main criteria for inappropriate direct oral anticoagulant dosing were defined according to the recommendations of the European Heart Rhythm Association.

Results

The median age of the study population was 72 years and 58% were women. Nine-hundred and eighty-seven patients were prescribed rivaroxaban, 658 apixaban, 239 edoxaban, and 120 dabigatran. A total of 498 patients (24.9%) did not receive the appropriate dose of direct oral anticoagulants. In a logistic regression model, advanced age, presence of chronic kidney disease and permanent atrial fibrillation, prescription of reduced doses of direct oral anticoagulants or edoxaban treatment, concomitant use of amiodarone treatment, and non-use of statin treatment were significantly associated with potentially inappropriate dosing of direct oral anticoagulants.

Conclusion

The study demonstrated that the prevalence of inappropriate direct oral anticoagulant dosing according to the European Heart Rhythm Association recommendations was 24.9% in patients with atrial fibrillation. Several demographic and clinical factors were associated with the inappropriate prescription of direct oral anticoagulants.
Appendix
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Metadata
Title
PrevAleNce and Associated factors of inappropriaTe dosing of direct Oral anticoaguLants In pAtients with Atrial Fibrillation: the ANATOLIA-AF Study
Authors
Umut Kocabaş
Isil Ergin
Veysel Yavuz
Selda Murat
Ibrahim Özdemir
Ömer Genç
Cihan Altın
Haşim Tüner
Bengisu Keskin Meriç
Ali Çoner
Elif İlkay Yüce
Bedrettin Boyraz
Onur Aslan
Ahmet Dal
Taner Şen
Ersin İbişoğlu
Aslan Erdoğan
Mehmet Özgeyik
Mevlüt Demir
Ziya Gökalp Bilgel
Büşra Güvendi Şengör
Örsan Deniz Urgun
Mustafa Doğduş
Deniz Dilan Naki Tekin
Sinem Çakal
Sercan Çayırlı
Arda Güler
Dilay Karabulut
Onur Dalgıç
Osman Uzman
Bektaş Murat
Şeyda Şahin
Umut Karabulut
Tarık Kıvrak
Muharrem Said Coşgun
Ferhat Özyurtlu
Mehmet Kaplan
Emre Özçalık
on behalf of the ANATOLIA-AF . study investigators
Publication date
17-12-2022
Publisher
Springer US
Published in
Cardiovascular Drugs and Therapy / Issue 3/2024
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-022-07409-w

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