Main factors of adherence to new oral anticoagulants and its dynamics in outpatients with nonvalvular atrial fibrillation: results of the ANTEY study

Лукина, Ю. В.; Кутишенко, Н. П.; Толпыгина, С. Н.; Воронина, В. П.; Дмитриева, Н. А.; Лерман, О. В.; Комкова, Н. А.; Загребельный, А. В.; Марцевич, С. Ю.; Драпкина, О. М.

doi:10.15829/1728-8800-2020-2680

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…In the group of patients with bleedings reported with OACs administration, 83.3% of patients refused to take these drugs and only 16.7% continued the previously recommended therapy ( p = 0.033). During the entire observation period, 80% of patients with non-valvular AF clearly followed the recommendations of the scientific center doctors regarding OACs administration [ 8 , 10 ].…”

Section: Resultsmentioning

confidence: 99%

Analysis of Adverse Events in the Treatment of Patients with Non-Valvular Atrial Fibrillation with Oral Anticoagulants: Data from the “ANTEY” Observational Study

et al. 2022

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Rationale: Therapy with oral anticoagulants (OACs) in patients with atrial fibrillation (AF) is based on finding the optimal balance of efficacy and safety of these drugs. Data from observational studies are an additional source of information for the adverse events (AEs) of pharmacotherapy. Objective: To investigate pharmacotherapy AEs with OACs in the “ANTEY” prospective observational study in patients with non-valvular atrial fibrillation (AF). Material and Methods: A total of 201 people were enrolled (83 (41.3%) were women). The age of subjects was 71.1 ± 8.7 years (data presented as mean with standard deviation). The study protocol included two face-to-face visits (contacts V0 and V1) and one follow-up (FU) phone contact which were made with the patient at an interval of 6 months. At V0, all patients were recommended to take one of the non-vitamin K antagonist oral anticoagulants (NOACs); starting from V1, warfarin could have been prescribed or NOAC could have been changed. Information about AEs and OACsadministration was collected at V0, V1, and FU. Results: During 1 year of observation, 15 out of 201 patients refused to take OACs, and 186 initiated the recommended drug. Rivaroxaban was initiated in 93 patients, dabigatran in 46, apixaban in 40, and warfarin in 7 patients. There were 55 AEs, 25 of which were serious (SAEs), including 4 deaths. Of the 30 AEs, there were 18 bleedings: eight (8.6%) occurred with the administration of rivaroxaban; four (8.5%) with dabigatran, three (7.5%) with apixaban, and three (42.9%) with warfarin. Differences in the incidence of bleeding events between NOACs and warfarin are statistically significant (p = 0.025). Any AEs increased the chance of nonadherence to treatment nine-fold: OR = 9.2 (CI95%: 3.6–23.5), p < 0.0001. Conclusions: The most typical and common AEs in real-world clinical practice settings treatment with OACs were bleedings, the incidence of which was approximately 8% to 9% in the treatment with NOACs and was much higher with warfarin, bleedings in the treatment with OACs are statistically significantly associated with nonadherence to the use of these drugs in the future.

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Section: Resultsmentioning

confidence: 99%

Analysis of Adverse Events in the Treatment of Patients with Non-Valvular Atrial Fibrillation with Oral Anticoagulants: Data from the “ANTEY” Observational Study

et al. 2022

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“…В рандомизированном исследовании ROCKETAF участвовало наибольшее число больных с ФП в возрасте ≥75 лет -44 %. Среди пациентов, включенных в рандоми зированные исследования ПОАК, наибольший риск ин сульта наблюдался именно в исследовании ROCKETAF, и это лучше всего соответствует характеристикам типич ного больного с ФП, который приходит на прием к рос сийскому врачу [15,16]. В популяции «в соответствии с проводимым лечением» ривароксабан снижал риск ин сульта и системной эмболии на 21 % в сравнении с варфа рином (отношение рисков (ОР) 0,79 при 95 % довери тельном интервале (ДИ) от 0,65 до 0,95; p=0,02 для ги потезы о большей эффективности ривароксабана) [3].…”

Section: эффективность и безопасность прямых пероральных антикоагулянтов у больных старческого возраста с фибрилляцией предсердийunclassified

Atrial fibrillation in old age: risk management and features of the use of direct oral anticoagulants

Канорский

2021

Kardiologiia

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Senile patients with atrial fibrillation (AF) are at a higher risk of thromboembolism and hemorrhage than younger patients. Three direct oral anticoagulants (DOAC), apixaban, dabigatran, and rivaroxaban, are registered in the Russian Federation and are extensively used for prevention of stroke in patients with AF. The DOAC treatment of older patients requires considering peculiarities of these patients, clinical situation and properties of individual drugs to achieve the balance of efficiency and safety and a comprehensive protection. According to studies of real clinical practice DOAC may have advantages over warfarin (reduced risk of fractures, diabetes mellitus, and dementia). Compliance with and constancy of the DOAC treatment are important for its efficiency, particularly in senile age. Results of clinical trials and real clinical practice studies have confirmed that rivaroxaban may provide a comprehensive protection for a senile patient with AF due to favorable indexes of efficiency and safety, beneficial effect on the risk of coronary events and impairment оf renal function, whereas once a day dosing of rivaroxaban improves the compliance with this treatment and its constancy.

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“…В группах двойной и тройной терапии не выявлено различий в приверженности к терапии. Число пациентов, приверженных к приему антикоагулянта, было схожим с исследованием АНТЕЙ, в котором 80 % пациентов продолжали принимать антикоагулянт через 12 [15]. По сравнению с российским регистром «РЕКОРД 3», в котором комбинированную АТТ продолжили принимать менее 50 % пациентов, в нашем исследовании отмечена лучшая приверженность пациентов к терапии [16].…”

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Results of Register in Patients with Acute Coronary Syndrome and Atrial Fibrillation Receiving Rivaroxaban

et al. 2021

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Aim To evaluate outcomes in patients with acute coronary syndrome and atrial fibrillation who receive rivaroxaban and the patients’ compliance with the antithrombotic therapy.Material and methods The study was performed from October 2017 through December 2019 and included 129 patients. Events between the discharge from the hospital and 12 months of follow-up were recorded. The primary endpoint was development of major, minor or requiring medical attention bleeding according to the TIMI scale. The secondary endpoint was a combination of recurrent myocardial infarction, nonfatal acute ischemic cerebrovascular disease, nonfatal systemic embolism, stent thrombosis, and cardiovascular mortality.Results 32 (24.8%) patients early terminated the antiplatelet treatment and 22 (17.1%) patients terminated the rivaroxaban treatment. 26 (20.2 %) patients had hemorrhagic complications. The highest incidence of hemorrhage was observed within the first 2 months after the discharge. None of the bleedings was fatal. Composite endpoint events were observed in 24 (18.6 %) patients, including 14 (10.9 %) who died from cardiovascular causes.Conclusion The compliance with the antiplatelet therapy was insufficient. The incidence of hemorrhagic complications was relatively high; minor and requiring medical attention hemorrhages mostly contributed to the structure of these complications. The observed incidence of recurrent ischemic events associated with a high mortality presents a more serious problem compared to hemorrhagic complications of the combination antiplatelet therapy and warrants a more aggressive tactics of the antiplatelet treatment in high-risk patients.

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Main factors of adherence to new oral anticoagulants and its dynamics in outpatients with nonvalvular atrial fibrillation: results of the ANTEY study

Cited by 6 publications

References 14 publications

Analysis of Adverse Events in the Treatment of Patients with Non-Valvular Atrial Fibrillation with Oral Anticoagulants: Data from the “ANTEY” Observational Study

Analysis of Adverse Events in the Treatment of Patients with Non-Valvular Atrial Fibrillation with Oral Anticoagulants: Data from the “ANTEY” Observational Study

Atrial fibrillation in old age: risk management and features of the use of direct oral anticoagulants

Results of Register in Patients with Acute Coronary Syndrome and Atrial Fibrillation Receiving Rivaroxaban

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