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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA2DS2-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use—out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.

Details

Title
Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?—Results of the Polish Atrial Fibrillation (POL-AF) Registry
Author
Szyszkowska, Anna 1 ; Kuźma, Łukasz 2 ; Wożakowska-Kapłon, Beata 3 ; Gorczyca-Głowacka, Iwona 3   VIAFID ORCID Logo  ; Jelonek, Olga 3   VIAFID ORCID Logo  ; Uziębło-Życzkowska, Beata 4   VIAFID ORCID Logo  ; Krzesiński, Paweł 4   VIAFID ORCID Logo  ; Wójcik, Maciej 5   VIAFID ORCID Logo  ; Błaszczyk, Robert 5   VIAFID ORCID Logo  ; Gawałko, Monika 6   VIAFID ORCID Logo  ; Kapłon-Cieślicka, Agnieszka 7 ; Tokarek, Tomasz 8   VIAFID ORCID Logo  ; Rajtar-Salwa, Renata 9 ; Bil, Jacek 10   VIAFID ORCID Logo  ; Wojewódzki, Michał 10 ; Szpotowicz, Anna 11 ; Krzciuk, Małgorzata 11 ; Bednarski, Janusz 12   VIAFID ORCID Logo  ; Bakuła, Elwira 12 ; Wełnicki, Marcin 13   VIAFID ORCID Logo  ; Mamcarz, Artur 13   VIAFID ORCID Logo  ; Tomaszuk-Kazberuk, Anna 1   VIAFID ORCID Logo 

 Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland 
 Department of Invasive Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland 
 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland; Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland 
 Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland 
 Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland 
 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, 6229 ER Maastricht, The Netherlands; Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, 45147 Essen, Germany 
 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland 
 Center for Invasive Cardiology, Electrotherapy and Angiology, 38-400 Nowy Sacz, Poland 
 Cardiology and Cardiovascular Interventions Clinical Department, The University Hospital, 30-688 Krakow, Poland 
10  Department of Invasive Cardiology, Center of Postgraduate Medical Education, 02-776 Warsaw, Poland 
11  Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland 
12  Department of Cardiology, St. John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland 
13  3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland 
First page
11939
Publication year
2022
Publication date
2022
Publisher
MDPI AG
ISSN
1661-7827
e-ISSN
1660-4601
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2724249382
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.