Current Status and Time Trends of Oral Anticoagulation Use Among Chinese Patients With Nonvalvular Atrial Fibrillation

Abstract

A trial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide. In 2008, the estimated agestandardized AF prevalence in China was 0.65%, suggesting that at least 4 million adults had AF, 1 and it was predicted that 5.2 million men and 3.1 million women aged >60 years will be affected by AF in China by 2050. 2AF increases the risk of stroke, and AF-related stroke is more fatal and disabling, compared with non-AF stroke.3 Oral anticoagulation (OAC) is recommended to reduce the risk of thromboembolic events in patients with AF with either a moderate or high risk of stroke. 4,5 Various registry studies report that nearly half to four fifths of high-risk AF patients were taking OAC therapy in developed countries 6-10 ; however, in Chinese patients with AF, OAC remains underused. 11During the past decade, the Chinese medical societies have made great efforts to improve stroke prevention among Background and Purpose-Reported rates of oral anticoagulation (OAC) use have been low among Chinese patients with atrial fibrillation (AF). With improved awareness, changing guidelines, this situation may be changing over time. We aimed to explore the current status and time trends of OAC use in Beijing. Methods-We used the data set from the Chinese Atrial Fibrillation Registry (CAFR), a prospective, multicenter, hospitalbased registry study involving 20 tertiary and 12 nontertiary hospitals in Beijing. A total of 11 496 patients with AF were enrolled from 2011 to 2014. Results-Seven thousand nine hundred seventy-seven eligible patients were included in this ancillary study.

Clinical analysis of antithrombotic treatment and occurrence of stroke in elderly patients with nonvalvular persistent atrial fibrillation

“…In our study, 41.10% patients with nonvalvular persistent AF received anticoagulant treatment (among whom 27.20% received NOACs), 42.20% patients received pure antiplatelet agents. The anticoagulation situation is superior to that of data in our country from 2011 to 2014 . In that report, only 36.5% patients received anticoagulant treatment.…”

Direct oral anticoagulants: analysis of worldwide use and popularity using Google Trends

“…In particular, the Google Trends score in China was close to zero, reflecting the fact that the search terms were less than 1% as popular as the worldwide peak. This is perhaps reflecting under-prescription trends, since recent data attests that oral anticoagulant therapy is still underprescribed in over two third of patients who may actually need antithrombotic drugs (13), that only recently were three of these drugs officially approved by the China Food and Drug Administration (CFDA) ( Table 1) (22), their cost in China is relatively high because they are mostly imported, and furthermore Google is probably less accessed in this country compared to others. Interestingly, the geographical distribution of Google Trends score of the four DOACs in US, Australia, Italy and Japan is also quite heterogeneous, as shown in Figure 7.…”

“…Although some very recent national studies support the common perception that prescription of these cuttingedge therapeutics may be constantly increasing worldwide, mostly as suitable replacement of historical anticoagulants (8)(9)(10)(11)(12)(13), no definitive statistics have been published regarding their real diffusion into different countries, nor is reliable data available on the general interest of patients and physicians about their usage.…”

Evaluation of endothelialization of left atrial appendage occluder by three-dimensional transesophageal echocardiography and its influence factors

“…However, the clinical application and e cacy of anticoagulants are limited by many factors such as dosage, patient compliance and adverse reactions. According to the literature, among the NVAF patients with CHA 2 DS 2 -VASc score ≥ 2 in Chinese population, 36.5% of them receive anticoagulants [5], and 44.4% of the anticoagulant users withdraw their medication within one year [6]. Left atrial appendage closure (LAAC) is a surgical procedure that blocks the ostium of left atrial appendage (LAA) to prevent thrombosis and thrombus detachment, so as to reduce the risk of stroke.…”