Abstract 18905: Novel Oral Anticoagulant Availability Increases Appropriate Use of Anticoagulants for Nonvalvular Atrial Fibrillation in the Elderly Aged >= 75 Years Old in Clinical Practice
Introduction: Registry data indicate that anticoagulation (AC) is underprescribed in patients (pts) with nonvalvular atrial fibrillation (NVAF), especially in the elderly. Novel oral anticoagulants (NOAC) offer several advantages compared with warfarin, including predictable pharmacokinetics, minimal food drug interactions and no INR monitoring. We examined the impact of NOAC availability on the appropriate use of oral AC for stroke prevention in elderly pts with NVAF.
Methods: Records of all pts aged ≥ 18 yrs old with NVAF within the Montefiore Medical Center between 1/1/07-12/31/14 were reviewed. The proportion of pts receiving any AC [warfarin, dabigatran, rivaroxaban or apixaban] was compared during the 4-year interval before (2007-2011, pre-) and after (2011-2014, post-) NOAC release in Oct 2010.
Results: 16526 pts with NVAF and CHADS2 score ≥ 1 were divided according to age (<65, 65-75, ≥75 years old). Among pts age ≥ 75, overall AC use increased significantly post-NOAC vs pre-NOAC (28.5% vs. 22.5 %, p<0.0001, Fig), coinciding with small decline in warfarin use and a predominant rise in NOAC use. Mean CHADS2 and CHADS2-VASC score increased over time (p<0.0001, Fig). The overall rate of AC use did not increase among pts < 75.
Conclusion: NOAC availability was associated with improvement in appropriate use of AC for stroke prevention among elderly pts ≥75 yrs old with NVAF.
Author Disclosures: Q. Zheng: None. C. Aneke-Nash: None. J.L. Halperin: Consultant/Advisory Board; Modest; AstraZeneca, Boehringer Ingelheim, Janssen, Pfizer. D.A. Vorchheimer: Speakers Bureau; Modest; Janssen.
- © 2016 by American Heart Association, Inc.