2017
DOI: 10.1016/j.ijcard.2017.01.098
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Permanent discontinuation of non vitamin K oral anticoagulants in real life patients with non-valvular atrial fibrillation

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Cited by 29 publications
(18 citation statements)
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“…This is clearly shown by our finding that patients starting on dabigatran were four times more likely to switch OAC in the first month of therapy than patients starting on apixaban. Only 7% of patients with NVAF in our study permanently discontinued NOAC therapy, which is approximately half the rate seen in Italy35 and approximately a third of that seen for rivaroxaban in Germany,18 and this may be a reflection of the growing confidence of both physicians and patients about long-term use of NOACs.…”
Section: Discussionmentioning
confidence: 56%
“…This is clearly shown by our finding that patients starting on dabigatran were four times more likely to switch OAC in the first month of therapy than patients starting on apixaban. Only 7% of patients with NVAF in our study permanently discontinued NOAC therapy, which is approximately half the rate seen in Italy35 and approximately a third of that seen for rivaroxaban in Germany,18 and this may be a reflection of the growing confidence of both physicians and patients about long-term use of NOACs.…”
Section: Discussionmentioning
confidence: 56%
“…After a mean follow-up of 533 days, the primary composite endpoint (stroke/transient ischemic attack (TIA) or death) occurred in 1740 (11.6%) in the dabigatran cohort vs 817 (8.6%) in the rivaroxaban cohort after a mean follow-up of 273 days, suggesting that non-persistence, independent of cohort, significantly increased the risk of the composite endpoint. Overall, discontinuation rates of either dabigatran or rivaroxaban were relatively high in this cohort, which is similar to previously reported ‘real-world’ data,4 although reasons for this are not discussed in the current study. Although there may be valid reasons for treatment cessation, it has also been suggested that this could be due to lack of knowledge by either the patient or the provider, or fear of potential complications of OAC therapy 5…”
supporting
confidence: 90%
“…6,7) On the contrary, dabigatran has idarucizumab, a dabigatran-specific reversal agent that can achieve an immediate and complete reversal of the anticoagulant effect, 9) but a specific antidote is not available for factor Xa inhibitors. Unfortunately, a relatively high rate (> 20% at 1 year) of discontinuation of dabigatran was reported in the RE-LY trial 4) and prospective cohort studies 10) due to dyspepsia or abdominal pain. As a result, in clinical practice, the majority of patients undergoing AF ablation take factor Xa inhibitors, and one or two doses of the factor Xa inhibitors are held prior to catheter ablation considering the risk of major bleeding events in most of the studies.…”
Section: Discussionmentioning
confidence: 99%