Use of novel oral anticoagulants increasing in A-fib

(HealthDay)—For patients with atrial fibrillation hospitalized with stroke or transient ischemic attack, use of novel oral anticoagulants (NOACs) has increased over time, according to a study published online June 9 in Circulation: Cardiovascular Quality and Outcomes.

Priyesh A. Patel, M.D., from the Duke Clinical Research Institute in Durham, N.C., and colleagues identified a cohort of 61,655 atrial fibrillation patients with ischemic stroke or transient ischemic attack, hospitalized between October 2010 and September 2012. The authors characterized the diffusion and patterns of use of warfarin and NOACs (dabigatran or rivaroxaban).

In the patient population, the researchers found that warfarin, dabigatran, and rivaroxaban were prescribed to 88.9, 9.6, and 1.5 percent, respectively. During the study period there was an increase in NOAC use from 0.04 percent to a plateau of 16 to 17 percent. Among eligible patients, anticoagulation rates did not change appreciably (93.7 percent in the first quarter of 2011 to 94.1 percent in the second quarter of 2012), indicative of a trend of switching from warfarin to NOACs. Among those discharged on NOAC versus warfarin therapy, several bleeding risk factors and CHA₂DS₂-VASc scores were lower.

"NOACs have had modest but growing uptake over time among atrial fibrillation patients hospitalized with stroke or transient ischemic attack and are prescribed to patients with lower stroke risk compared with warfarin," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.